Wayne Douglas Wightman, MD

Primary specialty

Emergency Medicine PhysicianTaxonomy code 207P00000X

License

A25658 Issued in CA

Practice address

23456 Hawthorne Blvd
Suite 160
Torrance, CA 90505-4716

Phone

(310) 375-2705

Fax

(310) 375-2701

NPI assigned

Sep 8, 2008

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Opted out of Medicare

Yes, effective Jun 8, 2013 through Jun 8, 2027

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Holtorf Medical Group, Inc

  • Pharmacy Technician
  • Torrance, CA
  • NPI 1871610733
  NPD (past)
• Holtorf Medical Group, Inc

  • Endocrinology, Diabetes & Metabolism Physician
  • Torrance, CA
  • NPI 1972729853
  NPD (past)

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

{
    "created_epoch": "1220832000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1220832000000",
    "number": "1356599963",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "23456 HAWTHORNE BLVD",
            "address_2": "SUITE 160",
            "city": "TORRANCE",
            "state": "CA",
            "postal_code": "905054716",
            "telephone_number": "310-375-2705",
            "fax_number": "310-375-2701"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "23456 HAWTHORNE BLVD",
            "address_2": "SUITE 160",
            "city": "TORRANCE",
            "state": "CA",
            "postal_code": "905054716",
            "telephone_number": "310-375-2705",
            "fax_number": "310-375-2701"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WIGHTMAN",
        "first_name": "WAYNE",
        "middle_name": "DOUGLAS",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2008-09-08",
        "last_updated": "2008-09-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "CA",
            "license": "A25658",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Videth Whitt, MD
• Jatturong Ron Wichianson, M.D.
• Charlotte Wickham
• Kathy Jean Wiechmann
• Chanel K Wiederkehr, DDS
• Tiffany Wiguna, MD
• Karen A Wijana, D.D.S.
• Harriet Janice Wilburne, M.D.
• Alexandra Wilcox, M.S. CCC-SLP
• Cindy Trinh Wilde, O.D.

• Emergency Medicine Physician in Torrance, CA
• Providers in Torrance, CA by specialty
• Emergency Medicine Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 8, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.