| William James Wickwire, MD | |
|
520 N Prospect Ave, Ste 302, Redondo Beach, CA 90277-3043 | |
| (310) 798-1515 | |
| (310) 798-3131 |
| Full Name | William James Wickwire |
|---|---|
| Gender | Male |
| Speciality | Dermatology |
| Experience | 40 Years |
| Location | 520 N Prospect Ave, Redondo Beach, California |
| Accepts Medicare Assignments | Yes. He accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1699779660 | NPI | - | NPPES |
| 00G650830 | Medicaid | CA | |
| WG65083E | Other | CA | PTAN |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207N00000X | Dermatology | G65083 (California) | Primary |
| Group Practice Name | Group PECOS PAC ID | No. of Members |
|---|---|---|
| William J Wickwire M D Inc A Professional Corporation | 7315974375 | 9 |
| Entity Name | William J Wickwire M D Inc A Professional Corporation |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1326119165 PECOS PAC ID: 7315974375 Enrollment ID: O20050720001209 |
| Entity Name | William J Wickwire M D Inc A Professional Corporation |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1326119165 PECOS PAC ID: 7315974375 Enrollment ID: O20080410000456 |
| Mailing Address | Practice Location Address |
|---|---|
| William James Wickwire, MD 520 N Prospect Ave, Ste 302, Redondo Beach, CA 90277-3043 Ph: (310) 798-1515 | William James Wickwire, MD 520 N Prospect Ave, Ste 302, Redondo Beach, CA 90277-3043 Ph: (310) 798-1515 |
Andrea Justine Borba, MD Dermatology Medicare: May Accept Medicare Assignments Practice Location: 514 N Prospect Ave Ste 103, Redondo Beach, CA 90277 Phone: 310-937-8555 Fax: 310-937-8556 | |
Anabella Pascucci, M.D. Dermatology Medicare: Accepting Medicare Assignments Practice Location: 514 N Prospect Ave Ste 103, Redondo Beach, CA 90277 Phone: 310-937-8555 Fax: 310-937-8556 | |
Geover Fernandez, MD Dermatology Medicare: Accepting Medicare Assignments Practice Location: 520 N Prospect Ave, Suite 302, Redondo Beach, CA 90277 Phone: 310-798-1515 Fax: 310-798-3131 | |
Annie Chiu, MD Dermatology Medicare: Not Enrolled in Medicare Practice Location: 1636 Aviation Blvd Ste 201, Redondo Beach, CA 90278 Phone: 310-939-9800 | |
John F Gebhard, M.D. Dermatology Medicare: Not Enrolled in Medicare Practice Location: 217 Avenida Del Norte, Redondo Beach, CA 90277 Phone: 310-540-7546 Fax: 310-540-1056 | |
Dr. Neal M Ammar, M.D. Dermatology Medicare: Accepting Medicare Assignments Practice Location: 520 N Prospect Ave, Ste 302, Redondo Beach, CA 90277 Phone: 310-798-1515 Fax: 310-798-3131 |