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Individual
DR. BRENT WILSON
Active
Individual
DR. BRENT WILSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
A84254
CA
207Q00000X
Family Medicine Physician
Primary
A842540
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00A842540
BLUE SHIELD
CA
05
—
00A842540
—
CA
01
—
A84254
BLUE CROSS
CA
01
—
A84254
COUNTY OF FRESNO
—
Enumeration date
07/25/2006
Last updated
09/04/2026
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