Provider Demographics
NPI:1649370487
Name:WECHSLER, CATHRYN JOHANNA (MD)
Entity type:Individual
Prefix:DR
First Name:CATHRYN
Middle Name:JOHANNA
Last Name:WECHSLER
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:437 W ADAMS PARK DR
Mailing Address - Street 2:
Mailing Address - City:COVINA
Mailing Address - State:CA
Mailing Address - Zip Code:91723-1803
Mailing Address - Country:US
Mailing Address - Phone:626-332-7390
Mailing Address - Fax:
Practice Address - Street 1:2025 E ROUTE 66
Practice Address - Street 2:
Practice Address - City:GLENDORA
Practice Address - State:CA
Practice Address - Zip Code:91740-4670
Practice Address - Country:US
Practice Address - Phone:626-335-4610
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-09-22
Last Update Date:2012-11-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA23593208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAA23593Medicaid