| Wynn Innovations Llc | |
| 
					1621 Shelter Cove Dr Greenwood CA 95635-9509  | |
| (916) 996-6377 | |
| Not Available | 
| Full Name | Wynn Innovations Llc | 
|---|---|
| Speciality | Family Medicine | 
| Location | 1621 Shelter Cove Dr, Greenwood, California | 
| Authorized Official Name and Position | Benjamin Wynn (OWNER) | 
| Authorized Official Contact | 9169966377 | 
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. | 
| Mailing Address | Practice Location Address | 
|---|---|
| Wynn Innovations Llc 1621 Shelter Cove Dr Greenwood CA 95635-9509 Ph: (916) 996-6377  | Wynn Innovations Llc 1621 Shelter Cove Dr Greenwood CA 95635-9509 Ph: (916) 996-6377  | 
| NPI Number | 1043928948 | 
|---|---|
| Provider Enumeration Date | 11/09/2022 | 
| Last Update Date | 12/19/2022 | 
| Identifier | Type | State | Issuer | 
|---|---|---|---|
| 1043928948 | NPI | - | NPPES | 
| Taxonomy | Type | License (State) | Status | 
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |