Brenton D Wynn, M.D.

Primary specialty

Pain Medicine (Physical Medicine & Rehabilitation) PhysicianTaxonomy code 2081P2900X

License

A73257 Issued in CA

Practice address

502 Euclid Ave Ste 200
National City, CA 91950-2984

Phone

(619) 434-4019

Fax

(619) 461-5663

NPI assigned

Aug 9, 2005

Sex

Male

Sole proprietor

No

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.

• Candelario Chiropractic a Professional Corporation

  • Chiropractor
  • Bonita, CA
  • NPI 1225189905
  NPD
• Martin C Fineman MD Med Corp

  • Internal Medicine Physician
  • San Diego, CA
  • NPI 1689979114
  NPD

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

HHS exclusion list flag

Flagged The directory lists this NPI on an HHS exclusion list. Confirm with the OIG exclusions search.

Credentials

Doctor of Medicine

Practice roles

Locations

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Jun 24, 2021.

{
    "created_epoch": "1123545600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1624492800000",
    "number": "1528069820",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "502 EUCLID AVE STE 200",
            "city": "NATIONAL CITY",
            "state": "CA",
            "postal_code": "919502984",
            "telephone_number": "619-434-4019",
            "fax_number": "619-461-5663"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "502 EUCLID AVE STE 200",
            "city": "NATIONAL CITY",
            "state": "CA",
            "postal_code": "919502984",
            "telephone_number": "619-434-4019",
            "fax_number": "619-461-5663"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WYNN",
        "first_name": "BRENTON",
        "middle_name": "D",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-08-09",
        "last_updated": "2021-06-24",
        "certification_date": "2021-06-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "CA",
            "license": "A73257",
            "primary": false
        },
        {
            "code": "2081P2900X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation, Pain Medicine",
            "state": "CA",
            "license": "A73257",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE GROUP NUMBER",
            "identifier": "W18884",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Carl-Marvin Kenneth-Elijah Wright
• Eva Yuting Wu, O.D.
• Hai Wu
• PO-Chin John Wu, M.D.
• Christine Irene Wyeth I, LEP
• Mariusz Witold Wysoczanski, M.D.
• Yan Pharmacy
• Adam D Yan, PHARMD
• Wai Yan, PHARM.D.
• Edgar Geronimo Yap Jr, MD

• All providers in National City, CA
• Pain Medicine (Physical Medicine & Rehabilitation) Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 24, 2021; 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.