Wandalyn Lane's National Provider Identifier (NPI) Details
Wandalyn Lane, MA
NPI: 1003941915
Enumeration Date: 2007-02-22
Last updated: 2019-03-11
Sole Proprietor: YES
Status: active
Postal Address: 1585 S D ST, 101, SAN BERNARDINO, CA
Phone: 909-388-2222
Primary Practice Address: 1501 HUGHES WAY, LONG BEACH, CA
Practice's phone: 310-221-6336