JEDEDIAH LARSEN WHEELER

CAPITOLA, CA
NPI1861796989
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy208000000X Pediatrics
(Licence: CA  20A11998)
Enumeration Date2011-01-04
Last Update Date2018-03-14
Business Address
JEDEDIAH LARSEN WHEELER DO
1820 41ST AVE STE D
CAPITOLA, CA 95010-2516
Phone number: 831-476-3000
Mailing Address
JEDEDIAH LARSEN WHEELER DO
3400 DATA DR ATTN: CREDENTIALING/PAYER ENROLLMENT
RANCHO CORDOVA, CA 95670-7956
Phone number:
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