BRIAN W WISTOW

MODESTO, CA
NPI1437109709
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy2085R0202X Radiology, Diagnostic Radiology
(Licence: CA  A33568)
Additional Taxonomies2085B0100X Radiology, Body Imaging
(Licence: CA  A33568)
2085U0001X Radiology, Diagnostic Ultrasound
(Licence: CA  A33568)
Enumeration Date2006-05-10
Last Update Date2011-03-01
Business Address
-- BRIAN W WISTOW M.D.
600 COFFEE RD
MODESTO, CA 95355-4201
Phone number: 209-524-1211
Mailing Address
-- BRIAN W WISTOW M.D.
600 COFFEE RD
MODESTO, CA 95355-4201
Phone number: 209-524-1211