Provider Demographics
NPI:1154659639
Name:WOHLIN, PATRICIA G
Entity Type:Individual
Prefix:MS
First Name:PATRICIA
Middle Name:G
Last Name:WOHLIN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:744 OBISPO AVE
Mailing Address - Street 2:
Mailing Address - City:LONG BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:90804-5026
Mailing Address - Country:US
Mailing Address - Phone:760-815-1419
Mailing Address - Fax:
Practice Address - Street 1:999 N TUSTIN AVE
Practice Address - Street 2:#124
Practice Address - City:SANTA ANA
Practice Address - State:CA
Practice Address - Zip Code:92705-3528
Practice Address - Country:US
Practice Address - Phone:714-547-5444
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-11-23
Last Update Date:2009-11-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA20698363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant