Individual provider Active NPI

Wendell E Wettstein, MD

  • General Practice Physician
  • Victorville, CA
National Provider Identifier
1871551564
Registry record updated Feb 8, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice PhysicianTaxonomy code 208D00000X
License
G31737 Issued in CA
Practice address
12408 Hesperia Rd
Suite 2
Victorville, CA 92395-7718
Phone
(760) 553-7000
NPI assigned
May 2, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 8, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Physician 208D00000X G31737 CA Primary

Addresses

Primary practice location

12408 Hesperia Rd
Suite 2
Victorville, CA 92395-7718

Mailing address

12370 Hesperia Rd
Suite 6
Victorville, CA 92395-7719
Phone (760) 245-4747

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
31737CAMDDental Hygienist
G31737CAMDGeneral Practice Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Uhs Corona Inc Past Accepting new patients
Rupal B, Shah, MD., Inc PastSince Oct 18, 2020 Accepting new patients

Interoperability endpoints

  • Direct secure messaging: wendell.wettstein.p2@direct.hvvmg.nextgenshare.com

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1146528000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1328659200000",
    "number": "1871551564",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12370 HESPERIA RD",
            "address_2": "SUITE 6",
            "city": "VICTORVILLE",
            "state": "CA",
            "postal_code": "923957719",
            "telephone_number": "760-245-4747"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12408 HESPERIA RD",
            "address_2": "SUITE 2",
            "city": "VICTORVILLE",
            "state": "CA",
            "postal_code": "923957718",
            "telephone_number": "760-553-7000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WETTSTEIN",
        "first_name": "WENDELL",
        "middle_name": "E",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-02",
        "last_updated": "2012-02-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "CA",
            "license": "G31737",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Victorville, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 8, 2012; 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.