Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 204F00000X | Transplant Surgeon | A128350 | CA |
N | 208200000X | Surgeon | 128350 | CA |
N | 208600000X | Surgeon | 128350 | CA |
NPI | 1689931818 |
---|---|
Provider Name | Dr. Steven Andrew Wisel |
First Address | Torrance, CA 90504-5513 |
Second Address | West Hollywood, CA 90048-1804 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 12/04/2012 |
Last Update Date | 05/10/2021 |