Wiedau, Martina H
Wiedau, Martina H is an individual health care provider with primary practice located at 300 Medical Plaza #B200, Los Angeles CA 90095-0001. She recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Neurology, Allopathic & Osteopathic Physicians / Neuromuscular Medicine. Allopathic & Osteopathic Physicians / Neurology is her primary health care specialty. Wiedau, Martina H can be contacted via phone (310) 794-1195.Contact Information
Primary practice address
300 Medical Plaza #B200
Los Angeles CA 90095-0001
Phone: (310) 794-1195
Fax: (310) 794-7491
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Neurology | 2084N0400X | A65989 | California |
| Allopathic & Osteopathic Physicians / Neuromuscular Medicine | 2084N0008X | A65989 | California |
Profile Details
| NPI number | 1528086824 |
|---|---|
| LBN Legal business name | Wiedau, Martina H |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jul 17th, 2006 |
| Last updated | Dec 30th, 2020 - about 4 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1528086824 | NPPES |
| California | MEDICAID | 00A659890 |
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