Wynn, Brenton D

Wynn, Brenton D is an individual health care provider with primary practice located at 502 Euclid Ave Ste 200 , National City CA 91950-2984. He recently has 2 registered licenses in different health care specialties including Other Service Providers / Specialist, Allopathic & Osteopathic Physicians / Pain Medicine. Allopathic & Osteopathic Physicians / Pain Medicine is his primary health care specialty. Wynn, Brenton D can be contacted via phone (619) 434-4019.

Contact Information

Primary practice address
502 Euclid Ave Ste 200 National City CA 91950-2984
Phone: (619) 434-4019
Fax: (619) 461-5663
Website:
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Health care specialties

SpecialtyCodeLicense #State
Other Service Providers / Specialist 174400000X A73257 California
Allopathic & Osteopathic Physicians / Pain Medicine 2081P2900X A73257 California

Profile Details

NPI number 1528069820
LBN Legal business name Wynn, Brenton D
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Aug 9th, 2005
Last updated Jun 24th, 2021 - 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1528069820 NPPES
California Other W18884 MEDICARE GROUP NUMBER

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