Individual
DR. BRIAN ROBERT WILSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
2020 SUTTER PL STE 203, DAVIS, CA 95616-6201
(530) 750-5880
(530) 750-5881
Mailing address
10470 OLD PLACERVILLE RD, SUITE 100, SACRAMENTO, CA 95827-2539
(800) 470-0071
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
A41052
CA
Other
Enumeration date
11/14/2005
Last updated
07/22/2015
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