Wistow, Brian W

Wistow, Brian W is an individual health care provider with primary practice located at 600 Coffee Rd , Modesto CA 95355-4201. He recently has 3 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Body Imaging, Allopathic & Osteopathic Physicians / Diagnostic Radiology, Allopathic & Osteopathic Physicians / Diagnostic Ultrasound. Allopathic & Osteopathic Physicians / Diagnostic Radiology is his primary health care specialty. Wistow, Brian W can be contacted via phone (209) 524-1211.

Contact Information

Primary practice address
600 Coffee Rd Modesto CA 95355-4201
Phone: (209) 524-1211
Fax:
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Body Imaging 2085B0100X A33568 California
Allopathic & Osteopathic Physicians / Diagnostic Radiology 2085R0202X A33568 California
Allopathic & Osteopathic Physicians / Diagnostic Ultrasound 2085U0001X A33568 California

Profile Details

NPI number 1437109709
LBN Legal business name Wistow, Brian W
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date May 10th, 2006
Last updated Mar 1st, 2011 - about 13 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1437109709 NPPES
California MEDICAID 00A335680

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