Lisa Marie Wieler, M.D.

Primary specialty

Diagnostic Radiology PhysicianTaxonomy code 2085R0202X

License

G46986 Issued in CA

Practice address

1100 Monterey St
Suite 210
San Luis Obispo, CA 93401-3102

Phone

(805) 542-9700

Fax

(805) 542-0584

NPI assigned

Nov 17, 2006

Last updated

Jul 8, 2007By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 4

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

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

{
    "created_epoch": "1163721600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1316011083",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1100 MONTEREY ST",
            "address_2": "SUITE 210",
            "city": "SAN LUIS OBISPO",
            "state": "CA",
            "postal_code": "934013102",
            "telephone_number": "805-542-9700",
            "fax_number": "805-542-0584"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1100 MONTEREY ST",
            "address_2": "SUITE 210",
            "city": "SAN LUIS OBISPO",
            "state": "CA",
            "postal_code": "934013102",
            "telephone_number": "805-542-9700",
            "fax_number": "805-542-0584"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WIELER",
        "first_name": "LISA",
        "middle_name": "MARIE",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-11-17",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "CA",
            "license": "G46986",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CHAMPUS",
            "identifier": "CH9716",
            "state": "CA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00G19230",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "P00138584",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE",
            "identifier": "G46986",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Deborah J Whitney, LMFT, #139267
• Nathan Anthony Whitsell
• Kayla Whitson, LPT
• Kirsten Anne Whitt, PT, DPT, CSCS
• Katharine Whittle-Utter, MA, MFT
• Danielle Nicole Wiemholt, MS, BCBA
• Anna E Wiens
• Colleen Wiest
• Joshua William Wiggins
• Justen F Wiggins, LCSW

• Diagnostic Radiology Physician in San Luis Obispo, CA
• Providers in San Luis Obispo, CA by specialty
• Diagnostic Radiology Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.