Edward Wieseltier, DO

Primary specialty

Physical Medicine & Rehabilitation PhysicianTaxonomy code 208100000X

License

20A15647 Issued in CA

Practice address

542 Broadway Ste G
Chula Vista, CA 91910-5304

Phone

(619) 425-8212

Fax

(619) 425-8337

NPI assigned

Dec 16, 2013

Sex

Male

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1387152000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1712275200000",
    "number": "1114348240",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "542 BROADWAY STE G",
            "city": "CHULA VISTA",
            "state": "CA",
            "postal_code": "919105304",
            "telephone_number": "619-425-8212",
            "fax_number": "619-425-8337"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "542 BROADWAY STE G",
            "city": "CHULA VISTA",
            "state": "CA",
            "postal_code": "919105304",
            "telephone_number": "619-425-8212",
            "fax_number": "619-425-8337"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "7590 Miramar Rd Ste C",
            "address_purpose": "LOCATION",
            "city": "San Diego",
            "state": "CA",
            "postal_code": "921264232",
            "country_code": "US",
            "telephone_number": "858-549-4255",
            "fax_number": "858-549-4552",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WIESELTIER",
        "first_name": "EDWARD",
        "name_prefix": "Dr.",
        "credential": "DO",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2013-12-16",
        "last_updated": "2024-04-05",
        "certification_date": "2024-04-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "FL",
            "license": "UO3586",
            "primary": false
        },
        {
            "code": "208100000X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation",
            "state": "CA",
            "license": "20A15647",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Taylor Whitney
• Teresa E Whitney, MHS, CADC-11, CCS
• Clara Wichmann, PTA, B.S.
• Kaitlin Widick
• Gregory J Wiener, M.D
• Renee Wiggins
• Charles Edward Wigle Jr., MFT
• Jeanne Elizabeth Wilcox, LMFT
• Elizabeth Wilke
• Roy Jim Wilkie

• Physical Medicine & Rehabilitation Physician in Chula Vista, CA
• Providers in Chula Vista, CA by specialty
• Physical Medicine & Rehabilitation Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 5, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.