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General NPI Number Information
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NPI Number | 1609559921
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Entity Type | Organization
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Legal Business Name | KEVIN WETHEY, M.D. A PROFESSIONAL CORPORATION
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Dates
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Enumeration Date | 08/11/2023
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Last Update Date | 05/03/2024
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Provider Practice Location Address
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Address Line | 750 N DIAMOND BAR BLVD STE 212
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City | DIAMOND BAR
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State | CA
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Zip | 91765-1023
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Country | US
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Telephone | 909-460-8733
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Fax | 909-752-9605
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Provider Business Mailing Address
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Address Line | 750 N DIAMOND BAR BLVD STE 212
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City | DIAMOND BAR
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State | CA
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Zip | 91765-1023
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Country | US
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Telephone | 909-460-8733
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Fax | 909-752-9605
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Authorized Official
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Title or Position | PSYCHIATRIST
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Name | DR. KEVIN WETHEY
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Credential | MD
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Telephone | 909-460-8733
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number |
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License Number State |
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