Individual
DR. BRETT W WILSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1670 E 120TH ST, LOS ANGELES, CA 90059-3026
(424) 338-1000
Mailing address
1434 RIO VISTA CT, SIMI VALLEY, CA 93065-5810
(805) 630-2915
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
207534
CA
363A00000X
Physician Assistant
Primary
2022008710
MO
Other
Enumeration date
10/03/2022
Last updated
04/16/2026
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