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Individual
DR. DOUGLAS RICHARD WILSON
Active
Individual
DR. DOUGLAS RICHARD WILSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
A71642
CA
207QH0002X
Hospice and Palliative Medicine (Family Medicine) Physician
A71642
CA
207R00000X
Internal Medicine Physician
A71642
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00A716420
—
CA
Enumeration date
03/23/2006
Last updated
11/11/2021
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