Provider Demographics
NPI:1902812449
Name:WISOT, ATHUR L (MD)
Entity Type:Individual
Prefix:DR
First Name:ATHUR
Middle Name:L
Last Name:WISOT
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Gender:M
Credentials:MD
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Mailing Address - Street 1:510 N PROSPECT AVE
Mailing Address - Street 2:SUITE 202
Mailing Address - City:REDONDO BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:90277-3028
Mailing Address - Country:US
Mailing Address - Phone:310-318-3010
Mailing Address - Fax:310-798-7304
Practice Address - Street 1:510 N PROSPECT AVE
Practice Address - Street 2:SUITE 202
Practice Address - City:REDONDO BEACH
Practice Address - State:CA
Practice Address - Zip Code:90277-3028
Practice Address - Country:US
Practice Address - Phone:310-318-3010
Practice Address - Fax:310-798-7304
Is Sole Proprietor?:No
Enumeration Date:2006-08-01
Last Update Date:2007-07-08
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Provider Licenses
StateLicense IDTaxonomies
CAG18617207VE0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207VE0102XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyReproductive Endocrinology