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1104469055
AVA MARIE WIEDEMANN
SAN DIEGO, CA
NPI
1104469055
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
363A00000X Physician Assistant
(Licence: CA PA57411)
Enumeration Date
2019-10-23
Last Update Date
2019-11-08
Business Address
AVA MARIE WIEDEMANN PA-C
9665 CHESAPEAKE DR STE 350
SAN DIEGO, CA 92123-1352
Phone number: 877-260-2261
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Mailing Address
AVA MARIE WIEDEMANN PA-C
2131 E GRETTA PL
PHOENIX, AZ 85022-3436
Phone number: 602-793-6456
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