Mylea N Wiley MD Inc.

Primary specialty

Hospitalist PhysicianTaxonomy code 208M00000X

Legal business name

MYLEA N WILEY MD INC.

Practice address

2755 Herndon Ave
Clovis, CA 93611-6801

Phone

(559) 324-4000

Fax

(559) 324-3744

NPI assigned

Jan 16, 2020

Organization subpart

No

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

Authorized official

Name

Mylea N Wiley, M.D.NPI 1275535627

Title

Owner/Physician

Phone

(513) 237-3242

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Mylea N Wiley, M.D.

  • Hospitalist Physician
  • Fresno, CA
  • NPI 1275535627

  Internal Medicine

  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1579132800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1721260800000",
    "number": "1760012959",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2595 E PERRIN AVE",
            "address_2": "#114",
            "city": "FRESNO",
            "state": "CA",
            "postal_code": "937205202",
            "telephone_number": "559-455-8944",
            "fax_number": "559-436-4395"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2755 HERNDON AVE",
            "city": "CLOVIS",
            "state": "CA",
            "postal_code": "936116801",
            "telephone_number": "559-324-4000",
            "fax_number": "559-324-3744"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MYLEA N WILEY MD INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-01-16",
        "last_updated": "2024-07-18",
        "certification_date": "2020-11-19",
        "status": "A",
        "authorized_official_last_name": "WILEY",
        "authorized_official_first_name": "MYLEA",
        "authorized_official_middle_name": "N",
        "authorized_official_title_or_position": "OWNER/PHYSICIAN",
        "authorized_official_telephone_number": "513-237-3242",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "208M00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Hospitalist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00A889170",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Hospitalist Physician in Clovis, CA
• Providers in Clovis, CA by specialty
• Hospitalist Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 18, 2024; 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.

Verify at the official NPI Registry.