| Organization Name: | GREGORY J WIENER M D PROFESSIONAL CORPORATION |
| NPI Number: | 1376728287 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | GREGORY JAMES WIENER (PRESIDENT) |
| Mailing Address: | 353 Church Ave Ste A Chula Vista |
| State: | CA US |
| Postal Code: | 919103906 |
| Phone Number: | 6195858883 |
| Fax Number: | |
| NPI Enumeration Date: | 01/09/2008 |
| NPI Last Update Date: | 08/14/2015 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 261Q00000X |
| License Number: | A41749 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | CA |
| Taxonomy Type: | Ambulatory Health Care Facilities |
| Taxonomy Classification: | Clinic/Center |
| Taxonomy Specialization: | |
| Taxonomy Definition: | A facility or distinct part of one used for the diagnosis and treatment of outpatients. "Clinic/Center" is irregularly defined, sometimes being limited to organizations serving specialized treatment requirements or distinct patient/client groups (e.g., radiology, poor, and public health). |