Provider Demographics
NPI:1760678148
Name:MCALLISTER, WESLEY JAMES (MD)
Entity Type:Individual
Prefix:
First Name:WESLEY
Middle Name:JAMES
Last Name:MCALLISTER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 2000
Mailing Address - Street 2:CALIFORNIA MEDICAL FACILITY
Mailing Address - City:VACAVILLE
Mailing Address - State:CA
Mailing Address - Zip Code:95696-2000
Mailing Address - Country:US
Mailing Address - Phone:707-453-7007
Mailing Address - Fax:707-453-7009
Practice Address - Street 1:1600 CALIFORNIA DR
Practice Address - Street 2:CALIFORNIA MEDICAL FACILITY
Practice Address - City:VACAVILLE
Practice Address - State:CA
Practice Address - Zip Code:95687
Practice Address - Country:US
Practice Address - Phone:707-453-7007
Practice Address - Fax:707-453-7009
Is Sole Proprietor?:No
Enumeration Date:2007-09-19
Last Update Date:2007-09-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG52795208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice