Active NPI
Cristina S. Wiese. M.D. Inc.
- Gastroenterology Physician
- Thousand Oaks, CA
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Gastroenterology Physician
- License
- A91425
- Legal business name
- CRISTINA S. WIESE. M.D. INC.
- Practice address
- 325 E. Rolling Oaks Dr.
Suite 100
Thousand Oaks, CA 91361-1283 - Phone
- (805) 557-0452
- Fax
- (805) 557-0471
- NPI assigned
- Oct 13, 2010
- Last updated
- Jul 25, 2012
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Dr. Cristina Susana Wiese, M.D.
- Title
- President
- Phone
- (805) 557-0452
Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Gastroenterology Physician | 207RG0100X | A91425 | CA | Primary |
Addresses
Primary practice location
325 E. Rolling Oaks Dr.
Suite 100
Thousand Oaks, CA 91361-1283
Mailing address
325 E. Rolling Oaks Dr.
Suite 100
Thousand Oaks, CA 91361-1283
Phone (805) 557-0452
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in CA
Enrollment records 1
National Provider Directory
National Provider DirectoryLocations
325 Rolling Oaks Dr
Ste 100
Thousand Oaks, CA 91361
Phone (805) 557-0452
Practitioners & affiliated clinicians
Practitioners 1
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.
-
- Gastroenterology Physician
- Thousand Oaks, CA
- NPI 1710921564
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1286928000000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1343174400000",
"number": "1306156260",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "325 E. ROLLING OAKS DR.",
"address_2": "SUITE 100",
"city": "THOUSAND OAKS",
"state": "CA",
"postal_code": "913611283",
"telephone_number": "805-557-0452",
"fax_number": "805-557-0471"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "325 E. ROLLING OAKS DR.",
"address_2": "SUITE 100",
"city": "THOUSAND OAKS",
"state": "CA",
"postal_code": "913611283",
"telephone_number": "805-557-0452",
"fax_number": "805-557-0471"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "CRISTINA S. WIESE. M.D. INC.",
"organizational_subpart": "NO",
"enumeration_date": "2010-10-13",
"last_updated": "2012-07-25",
"status": "A",
"authorized_official_last_name": "WIESE",
"authorized_official_first_name": "CRISTINA",
"authorized_official_middle_name": "SUSANA",
"authorized_official_title_or_position": "PRESIDENT",
"authorized_official_telephone_number": "805-557-0452",
"authorized_official_name_prefix": "Dr.",
"authorized_official_credential": "M.D."
},
"taxonomies": [
{
"code": "207RG0100X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Internal Medicine, Gastroenterology",
"state": "CA",
"license": "A91425",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Thousand Oaks, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 25, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.