MARK D WIEDERHOLD (NPI# 1598015745) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1598015745 |
| Entity Type | Individual |
| Full Name | MARK D WIEDERHOLD |
| Credential | M.D. |
| Practice Address |
9565 Waples St Suite 200 San Diego CA 92121-2986 |
| Practice Telephone | 8586420267 |
| Practice Fax Number | 8586420285 |
| Mailing Telephone | 8586420267 |
| Mailing Fax Number | 8586420285 |
| Enumeration Date | 2012-09-14 |
| Last Update Date | 2012-09-14 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207R00000X | Internal Medicine | G66151 | CA | Allopathic & Osteopathic Physicians |
| Street Address |
9565 WAPLES ST SUITE 200 |
| City | SAN DIEGO |
| State | CA |
| Zip Code | 92121-2986 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1225644917 | Anna Hand | Physical Therapist | 5945 Pacific Center Blvd Bldg #510, San Diego, CA 92121 | 2020-09-18 |
| 1972138030 | Lamarr Joyner | Licensed Vocational Nurse | 5930 Conerstone Court West, Suite 300, San Diego, CA 92121 | 2020-03-10 |
| 1396383212 | La Jolla Professional Plastic Surgery | Plastic Surgery | 4510 Executive Dr. Suite 105, San Diego, CA 92121 | 2019-12-11 |
| 1841852472 | Unmanned Systems Operations Group | Air Carrier | 4655 Executive Dr., Suite 700, San Diego, CA 92121 | 2019-07-03 |
| 1861051922 | Grace Getchell | Behavior Technician | 3978 Sorrento Valley Blvd. #100, San Diego, CA 92121 | 2019-06-11 |
| 1720643299 | Megan Jean Bathen | Behavior Technician | Cortica Behavioral Inc., 7090 Miratech Dr., San Diego, CA 92121 | 2019-05-09 |
| 1346804366 | Daniel Melita | Massage Therapist | 11689 Sorrento Valley Rd Ste Q, San Diego, CA 92121 | 2019-04-25 |
| 1831674464 | Stepahnie Becerra | Behavior Technician | 3978 Sorrento Valley Blvd Suite 100, San Diego, CA 92121 | 2018-09-28 |
| 1265915466 | Ailyn Martinez | Behavior Technician | 3978 Sorrento Valley Bldv, 100, San Diego, CA 92121 | 2018-09-13 |
| 1790265163 | Genben Lifesciences Corporation | Public Health or Welfare | 6370 Lusk Blvd Ste F205, San Diego, CA 92121 | 2018-08-15 |
| Find all providers in zip 92121 | ||||
| Taxonomy Code | 207R00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Internal Medicine |
| A physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults and the elderly. Internists are trained in the diagnosis and treatment of cancer, infections and diseases affecting the heart, blood, kidneys, joints and digestive, respiratory and vascular systems. They are also trained in the essentials of primary care internal medicine, which incorporates an understanding of disease prevention, wellness, substance abuse, mental health and effective treatment of common problems of the eyes, ears, skin, nervous system and reproductive organs. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source; 7/1/2011: modified source] - Additional Resources: American Board of Internal Medicine, 2007. http://www.abim.org/. American Osteopathic Board of Internal Medicine, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Internal Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Internal Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1184233645 | Svr Medical PC | Internal Medicine | 4440 Euclid Ave Ste E, San Diego, CA 92115-4522 | 2020-07-30 |
| 1023639176 | Arthur Wong | Internal Medicine | 4222 Kansas St Unit 2, San Diego, CA 92104-1802 | 2020-04-29 |
| 1679102461 | Santosh Vetticaden | Internal Medicine | 6420 Mesa Norte Dr, San Diego, CA 92130-6852 | 2020-04-03 |
| 1225664964 | Andres Smith M.d. A Professional Medical Corporation | Internal Medicine | 6244 El Cajon Blvd Ste 29, San Diego, CA 92115-3918 | 2020-03-13 |
| 1154972388 | Kimberly Hall Fernandez | Internal Medicine | 700 W E St Unit 2101, San Diego, CA 92101-5993 | 2019-09-29 |
| 1992289300 | Sd Healthcare Solutions | Internal Medicine | 5943 Thorn St, San Diego, CA 92105-3916 | 2018-09-21 |
| 1992295331 | Alera Inc | Internal Medicine | 2667 Camino Del Rio S Ste 307-6, San Diego, CA 92108 | 2018-05-11 |
| 1275020844 | Lf Capital Inc | Internal Medicine | 438 Camino Del Rio S Ste 203, San Diego, CA 92108-3546 | 2018-04-18 |
| 1710401302 | Ca Post Acute Specialists PC | Internal Medicine | 3525 Del Mar Heights Rd # 966, San Diego, CA 92130-2199 | 2017-07-26 |
| 1063933604 | John Jackson Howard | Internal Medicine | 4616 Patricia Pl, San Diego, CA 92115-1934 | 2017-07-05 |
| Find all providers in SAN DIEGO | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.