Wilson, Timothy

Wilson, Timothy is an individual health care provider with primary practice located at 2121 Santa Monica Blvd , Santa Monica CA 90404-2303. He recently has only one registered license in Allopathic & Osteopathic Physicians / Urology, which is considered as his primary health care specialty. Wilson, Timothy can be contacted via phone (310) 582-7137.

Contact Information

Primary practice address
2121 Santa Monica Blvd Santa Monica CA 90404-2303
Phone: (310) 582-7137
Fax: (310) 582-7140
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Urology 208800000X G57490 California

Profile Details

NPI number 1912005422
LBN Legal business name Wilson, Timothy
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Sep 20th, 2006
Last updated Sep 14th, 2021 - about 4 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1912005422 NPPES
California MEDICAID 00G574900

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