Basic Information
| Provider Information | |||||||||
| NPI: | 1245993229 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | WHEELER | ||||||||
| FirstName: | MICHAEL | ||||||||
| MiddleName: | |||||||||
| NamePrefix: | MR. | ||||||||
| NameSuffix: | II | ||||||||
| Credential: | RN | ||||||||
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| Mailing Information | |||||||||
| Address1: | 51400 CALLE GUATEMALA | ||||||||
| Address2: | |||||||||
| City: | LA QUINTA | ||||||||
| State: | CA | ||||||||
| PostalCode: | 922532998 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6462495774 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | 47915 OASIS ST | ||||||||
| Address2: | |||||||||
| City: | INDIO | ||||||||
| State: | CA | ||||||||
| PostalCode: | 922016950 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7608638650 | ||||||||
| FaxNumber: | |||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 10/18/2021 | ||||||||
| LastUpdateDate: | 10/18/2021 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 10/18/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 163WP0808X | RN95188653 | CA | Y | Nursing Service Providers | Registered Nurse | Psych/Mental Health |
No ID Information.