Healthcare Provider Details

I. General information

NPI: 1881599850
Provider Name (Legal Business Name): WYNN MEDICAL CENTER SAN DIEGO
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/10/2026
Last Update Date: 10/10/2026
Certification Date: 10/10/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4444 EL CAJON BLVD STE 6
SAN DIEGO CA
92115-4392
US

IV. Provider business mailing address

4444 EL CAJON BLVD STE 6
SAN DIEGO CA
92115-4392
US

V. Phone/Fax

Practice location:
  • Phone: 619-285-1522
  • Fax: 619-285-0714
Mailing address:
  • Phone: 619-285-1522
  • Fax: 619-285-0714

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207N00000X
TaxonomyDermatology Physician
License Number
License Number StateNULL
# 2
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number
License Number StateNULL
# 3
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number
License Number StateNULL
# 4
Primary TaxonomyN
Taxonomy Code207RR0500X
TaxonomyRheumatology Physician
License Number
License Number StateNULL
# 5
Primary TaxonomyN
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number
License Number StateNULL

VIII. Authorized Official

Name: DR. HUYNH W TRAN
Title or Position: PRESIDENT/CEO
Credential:
Phone: 619-285-1522