MEDICARE: WESLEY CHARLES ADAMS PA-C

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
1	363AM0700X	Medical Physician Assistant	PA20509	CA

General Provider Information

NPI Number	:	1912233438
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	WESLEY CHARLES ADAMS PA-C

Provider Business Mailing Address
First Line	:	3559 E SOUTH ST
Second Line	:
City	:	LONG BEACH
State	:	CA
Zip	:	90805-4519
Country	:	US
Telephone Number	:	562-354-4410
Fax Number	:

Provider Business Practice Location Address
First Line	:	3559 E SOUTH ST
Second Line	:
City	:	LONG BEACH
State	:	CA
Zip	:	90805-4519
Country	:	US
Telephone Number	:	562-354-4410
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/19/2009
Last Update Date	:	12/22/2021

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Directions to “ WESLEY CHARLES ADAMS PA-C” Practice Location

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