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NPI Code Detail

MEDICARE: DELVON WINGFIELD

MEDICARE: DELVON WINGFIELD
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
1171M00000XCase Manager/Care Coordinator

General Provider Information

NPI Number : 1407672603
Entity Type Code : Individual
Provider Name (Legal Business Name) : DELVON WINGFIELD
Provider Business Mailing Address
First Line : 3491 KURTZ ST STE 150
Second Line :
City : SAN DIEGO
State : CA
Zip : 92110-4430
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 3491 KURTZ ST STE 150
Second Line :
City : SAN DIEGO
State : CA
Zip : 92110-4430
Country : US
Telephone Number : 657-337-6037
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/03/2024
Last Update Date : 12/30/2025

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Directions to “ DELVON WINGFIELD ” Practice Location

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