Provider Demographics
NPI:1124061296
Name:WETZEL, GIHAN K (DO)
Entity type:Individual
Prefix:
First Name:GIHAN
Middle Name:K
Last Name:WETZEL
Suffix:
Gender:
Credentials:DO
Other - Prefix:
Other - First Name:GIHAN
Other - Middle Name:
Other - Last Name:MAKAREM
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 10070
Mailing Address - Street 2:
Mailing Address - City:WESTMINSTER
Mailing Address - State:CA
Mailing Address - Zip Code:92685-0070
Mailing Address - Country:US
Mailing Address - Phone:562-809-3543
Mailing Address - Fax:
Practice Address - Street 1:3751 KATELLA AVE
Practice Address - Street 2:
Practice Address - City:LOS ALAMITOS
Practice Address - State:CA
Practice Address - Zip Code:90720-3113
Practice Address - Country:US
Practice Address - Phone:714-456-8888
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-06-14
Last Update Date:2025-04-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA20A7357207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00AX73570Medicaid
G66777Medicare UPIN
CAW20A7357AMedicare PIN