WILLIAM J WICKWIRE, M.D., INC.,
Dermatology at Prospect Ave, Redondo Beach, CA

License number
California G650830
Category
Osteopathic Medicine
Type
Dermatology
Owner
Name: DR. WILLIAM J WICKWIRE M.D.
Title: OWNER
Phone: (310) 798-1515
Address
Address
520 N Prospect Ave STE 302, Redondo Beach, CA 90277
National Provider ID: 1326119165
LicenseFiles verified this license of Nov 7, 2017 at the National Plan and Provider Enumeration System.

Organization information

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WILLIAM J. WICKWIRE, M.D. INC., A PROFESSIONAL CORPORATION

520 N Prospect Ave SUITE 302, Redondo Beach, CA 90277

Industry:
Medical Doctor's Office
Doing business as:
William J Wickwire MD<br>Beach City Dermatology
Registration:
Mar 12, 1999
Phone:
(310) 798-1515 (Phone)
State ID:
C2158516
Business type:
Articles of Incorporation
Office Manager, Managers:
Neal M. Ammar (Dermatology, President),Janis Gersh (Office Manager),Fariba Seraj (Nurse Practitioner),...
Agent:
Neal M. Ammar, M.d,Redondo Beach, CA 90277 (Physical)

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