MR. Gary Dewayne Wiley JR., PA-C

NPI #1427885656 in Marina Del Rey, California

Provider Information

NPI Number: 1427885656
Entity Type: Individual
Name: MR. Gary Dewayne Wiley JR., PA-C
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Physician Assistant
Credential: PA-C
Enumeration Date: Sep 19, 2024
Last Updated: Sep 27, 2024

Practice Location

Address: 4011 VIA MARINA APT 107
City: Marina Del Rey
State: California
ZIP Code: 90292-8201
Phone: (360) 441-4248

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Physician Assistant	363A00000X	Primary

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