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NPI Code Detail

MEDICARE: MALCOLM JOHN WEHRLE MD, A PROFESSIONAL CORPORATION

MEDICARE: MALCOLM JOHN WEHRLE MD, A PROFESSIONAL CORPORATION
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
1207LA0401XAddiction Medicine (Anesthesiology) PhysicianG64523CA

General Provider Information

NPI Number : 1528513140
Entity Type Code : Organization
Provider Name (Legal Business Name) : MALCOLM JOHN WEHRLE MD, A PROFESSIONAL CORPORATION
Provider Business Mailing Address
First Line : 1203 E VERMONT AVE
Second Line :
City : ANAHEIM
State : CA
Zip : 92805-5622
Country : US
Telephone Number : 714-997-2674
Fax Number : 206-426-5175
Provider Business Practice Location Address
First Line : 1203 E VERMONT AVE
Second Line :
City : ANAHEIM
State : CA
Zip : 92805-5622
Country : US
Telephone Number : 714-997-2674
Fax Number : 206-426-5175
Authorized Official
Title or Position : PRESIDENT
Name : DR. MALCOLM WEHRLE
Credential : M.D.
Telephone Number : 818-653-7186
Provider Enumeration Date : 08/24/2016
Last Update Date : 07/28/2021

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