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General NPI Number Information
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NPI Number | 1780433698
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Entity Type | Organization
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Legal Business Name | PAUL J WISNIEWSKI DO INC
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Dates
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Enumeration Date | 05/14/2024
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Last Update Date | 10/31/2025
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Provider Practice Location Address
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Address Line | 18523 CORWIN RD STE A
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City | APPLE VALLEY
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State | CA
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Zip | 92307-2300
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Country | US
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Telephone | 909-353-5285
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Fax | 909-752-8719
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Provider Business Mailing Address
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Address Line | 18523 CORWIN RD STE A
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City | APPLE VALLEY
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State | CA
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Zip | 92307-2300
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Country | US
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Telephone | 909-353-5285
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Fax | 909-752-8719
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Authorized Official
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Title or Position | DO
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Name | PAUL WISNIEWSKI
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Credential |
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Telephone | 407-335-6950
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208600000X
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Taxonomy Name | Surgery Physician
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 2086S0127X
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Taxonomy Name | Trauma Surgery Physician
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License Number |
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License Number State |
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