MEDICARE: DR. JOSEPH MICHAEL WIENER M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207R00000X	Internal Medicine Physician	C161178	CA
2	207R00000X	Internal Medicine Physician	233307	NY

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1952388845
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JOSEPH MICHAEL WIENER M.D.

Provider Business Mailing Address
First Line	:	PO BOX 95000-4145
Second Line	:
City	:	PHILADELPHIA
State	:	PA
Zip	:	19195-0001
Country	:	US
Telephone Number	:	212-492-5500
Fax Number	:

Provider Business Practice Location Address
First Line	:	8767 WILSHIRE BLVD FL 3
Second Line	:
City	:	BEVERLY HILLS
State	:	CA
Zip	:	90211-2714
Country	:	US
Telephone Number	:	310-385-6031
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	12/30/2005
Last Update Date	:	12/22/2023

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