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Individual

WILSON CHICK

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
11370 ANDERSON ST, STE 2960, LOMA LINDA, CA 92354-3450
(909) 558-6422
Mailing address
PO BOX 1740, LOMA LINDA, CA 92354-0240
(909) 558-6422

Taxonomy

Speciality
Code
Description
License number
State
207ZC0500X
Cytopathology Physician
Primary
A55294
CA
207ZP0101X
Anatomic Pathology Physician
A55294
CA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
00A552940
CA
Enumeration date
07/25/2006
Last updated
09/11/2025
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