Individual provider · Type 1 NPI

Ava Marie Wiedemann, PA-C

Physician Assistant · San Diego, CA

NPI number 1104469055 Active

Practice location

9665 Chesapeake Dr Ste 350
San Diego, CA 92123-1352

Call (877) 260-2261 Map

Mailing address

2131 E Gretta Pl
Phoenix, AZ 85022-3436

Other practice locations

2101 Rosecrans Ave # 3230, El Segundo, CA 90245-4749 · (323) 628-8671

Specialties and licenses

Taxonomy	Code	License
Physician Assistant Primary	363A00000X	PA57411 (CA)

Physician Assistant: A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, orde…

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About NPI 1104469055

Ava Marie Wiedemann, PA-C's National Provider Identifier is 1104469055, issued on Oct 23, 2019. The primary taxonomy on file is Physician Assistant (363A00000X), and the practice location is in San Diego, CA. The record was last updated on Nov 8, 2019.