Paul John Wisniewski
Surgeon Surgical Critical Care
400 N Pepper Ave Ste 308
Colton
, California 92324-1801
Paul John Wisniewski
Surgeon Surgical Critical Care
400 N Pepper Ave Ste 308
Colton
, California 92324-1801
(909) 580-1363
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About
Features
Specialties
- Surgeon
- Surgical Critical Care
Languages spoken
- English
Location
First Address
- Paul John Wisniewski
- Po Box 670
- Redlands, CA
- Zip : 92373-0221
- Fax : (909) 580-1363
- Phone : (909) 580-3353
Second Address
- Paul John Wisniewski
- 400 N Pepper Ave Ste 308
- Colton, CA
- Zip : 92324-1801
- Fax : (909) 580-1363
- Phone : (909) 580-3353
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Is Paul John Wisniewski a sole practitioner?
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Scope of Practice
| Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
|---|---|---|---|---|
| N | 208200000X | Surgeon | 20A9062 | CA |
| N | 208600000X | Surgeon | 20A9062 | CA |
| Y | 2086S0102X | Surgical Critical Care | CA209062 | CA |
| N | 2086S0102X | Surgical Critical Care | OS 12023 | FL |
National Provider Identifier
| NPI | 1063674190 |
|---|---|
| Provider Name | Paul John Wisniewski |
| First Address | Redlands, CA 92373-0221 |
| Second Address | Colton, CA 92324-1801 |
| Gender | M |
| NPI Entity type | Individual |
| Is Sole Proprietor | No |
| Is Organization Subpart | N/A |
| Enumeration Date | 30/06/2008 |
| Last Update Date | 16/08/2017 |
NPI Footnotes
What is the National Provider Identifier (NPI)
Provider Location Address
Provider Mailing Address
Entity Type Code
1= Person: individual human being who furnishes health care;
2= Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)
What is a Subpart?
Provider Other Organization Name
1 = former name;
2 = professional name;
3 = doinq business as (d/b/ a) name;
4 = former legal business name;
5 = other.