Provider Demographics
NPI:1932162542
Name:GAIL E WEHNER
Entity Type:Organization
Organization Name:GAIL E WEHNER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER PHYSICAL THERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:GAIL
Authorized Official - Middle Name:E
Authorized Official - Last Name:WEHNER
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:310-828-2188
Mailing Address - Street 1:1821 WILSHIRE BOULEVARD
Mailing Address - Street 2:SUITE 400
Mailing Address - City:SANTA MONICA
Mailing Address - State:CA
Mailing Address - Zip Code:90403
Mailing Address - Country:US
Mailing Address - Phone:310-828-2188
Mailing Address - Fax:310-829-1379
Practice Address - Street 1:1821 WILSHIRE BOULEVARD
Practice Address - Street 2:SUITE 400
Practice Address - City:SANTA MONICA
Practice Address - State:CA
Practice Address - Zip Code:90403
Practice Address - Country:US
Practice Address - Phone:310-828-2188
Practice Address - Fax:310-829-1379
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-04-07
Last Update Date:2016-01-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAW16381Medicare PIN