S. Gayle Widyolar, M.D., Inc.
LBN: S. Gayle Widyolar, M.D., Inc.
S. Gayle Widyolar, M.D., Inc. is an health care organization with primary practice located at 21 Montecito Dr , Corona Del Mar CA 92625-1017. The organization recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Dermatology, Allopathic & Osteopathic Physicians / Dermatopathology. Allopathic & Osteopathic Physicians / Dermatology is the primary health care specialty.
S. Gayle Widyolar, M.D., Inc. can be contacted via phone (949) 760-2552, or through Widyolar, Sheila Gayle via phone (949) 760-2552.
Contact Information
Primary practice address
21 Montecito Dr
Corona Del Mar CA 92625-1017
Phone: (949) 760-2552
Fax: (949) 706-3808
Website:
Authorized official contact:
Name: Widyolar, Sheila Gayle Doctor of Medicine (MD)
Phone: (949) 760-2552
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Dermatology | 207N00000X | ||
| Allopathic & Osteopathic Physicians / Dermatopathology | 207ND0900X |
Profile Details
| NPI number | 1457538415 |
|---|---|
| LBN Legal business name | S. Gayle Widyolar, M.D., Inc. |
| DBA Doing business as | |
| Authorized official | Widyolar, Sheila Gayle Doctor of Medicine (MD) |
| Entity | Organization |
| Organization subpart 1 | No |
| Enumeration date | Jan 22nd, 2008 |
| Last updated | Jun 20th, 2008 - about 17 years ago |
1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1457538415 | NPPES |
| California | MEDICAID | 00G250560 |
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