Organization
CHAD WILDE MD, A MEDICAL CORPORATION
Active
Other names
Simi Pain Center
Organization subpart
No
Provider details
NPI number
Authorized official
DR. CHAD WILDE MD, MS (PRESIDENT)
(805) 504-4810
Entity
Organization
Contact information
Practice address
1350 E LOS ANGELES AVE, SUITE 3 A, SIMI VALLEY, CA 93065-2898
(805) 504-4810
Mailing address
1350 E LOS ANGELES AVE, SUITE 3 A, SIMI VALLEY, CA 93065-2898
(805) 504-4810
Taxonomy
Speciality
Code
Description
License number
State
207LP2900X
Pain Medicine (Anesthesiology) Physician
Primary
A96633
CA
Other
Enumeration date
12/21/2006
Last updated
09/10/2010
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