Individual provider · Type 1 NPI

Dalton Andrew Wise

Student in an Organized Health Care Education/Training Program · Torrance, CA

NPI number 1265015572 Active

Practice location

1000 W Carson St
Torrance, CA 90502-2059

Call (424) 306-6219 Map

Mailing address

800 Bradbury Dr SE Ste 116
Albuquerque, NM 87106-4310

Specialties and licenses

TaxonomyCodeLicense
Student in an Organized Health Care Education/Training Program Primary 390200000XNone listed
Clinical Pathology/Laboratory Medicine Physician 207ZP0105XMD2024-1078 (NM)

Student in an Organized Health Care Education/Training Program: An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.

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About NPI 1265015572

Dalton Andrew Wise's National Provider Identifier is 1265015572, issued on May 4, 2021. The primary taxonomy on file is Student in an Organized Health Care Education/Training Program (390200000X), and the practice location is in Torrance, CA. The record was last updated on May 15, 2026.