Individual
DR. DONALD R WILSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
715 LINDA FALLS TER, ANGWIN, CA 94508-9684
(707) 965-2181
(707) 965-3576
Mailing address
PO BOX 714, ANGWIN, CA 94508-0714
(707) 965-2181
(707) 965-3576
Taxonomy
Speciality
Code
Description
License number
State
208G00000X
Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
Primary
A24934
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00A249340
—
CA
Enumeration date
01/17/2006
Last updated
04/07/2011
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