# CHAD WILDE MD, A MEDICAL CORPORATION

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Simi Pain Center
- **Organization subpart:** No

## Provider details

- **NPI number:** 1124182001
- **Authorized official:** DR. CHAD WILDE MD, MS (PRESIDENT)
- **Authorized official phone:** (805) 504-4810

## Contact information

- **Practice address:** 1350 E LOS ANGELES AVE, SUITE 3 A, SIMI VALLEY, CA 93065-2898
- **Practice address phone:** (805) 504-4810
- **Mailing address:** 1350 E LOS ANGELES AVE, SUITE 3 A, SIMI VALLEY, CA 93065-2898
- **Mailing address phone:** (805) 504-4810

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207LP2900X | Pain Medicine (Anesthesiology) Physician | A96633 | CA | Yes |

## Other

- **Enumeration date:** 12/21/2006
- **Last updated:** 09/10/2010