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Organization
TIFFANY DAWN WILSON, M.D., INC.
Active
Organization
TIFFANY DAWN WILSON, M.D., INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. TIFFANY D WILSON MD (OWNER)
(949) 559-4480
Entity
Organization
Contact information
Practice address
37 CREEK RD STE 140, IRVINE, CA 92604-4724
(949) 559-4480
(949) 262-7072
Mailing address
PO BOX 1744, SUISUN CITY, CA 94585-4744
(657) 241-3600
(657) 241-7708
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
CB280062
MEDICARE PTAN
CA
01
—
DY3730
MEDICARE RAILROAD
CA
Enumeration date
09/07/2006
Last updated
02/11/2026
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