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NPI Code Detail

MEDICARE: MR. MICHAEL TERRY WIMPIE II

MEDICARE: MR. MICHAEL TERRY WIMPIE II
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
1373H00000XDay Training/Habilitation Specialist

General Provider Information

NPI Number : 1265361802
Entity Type Code : Individual
Provider Name (Legal Business Name) : MR. MICHAEL TERRY WIMPIE II
Provider Business Mailing Address
First Line : 1260 MORENA BLVD
Second Line :
City : SAN DIEGO
State : CA
Zip : 92110-3889
Country : US
Telephone Number : 619-398-0355
Fax Number :
Provider Business Practice Location Address
First Line : 1260 MORENA BLVD STE 100
Second Line :
City : SAN DIEGO
State : CA
Zip : 92110-3850
Country : US
Telephone Number : 619-398-0355
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/19/2026
Last Update Date : 05/19/2026

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Directions to “ MR. MICHAEL TERRY WIMPIE II ” Practice Location

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