Organization
ROBERT M. WILSON, M.D. INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ROBERT M WILSON M.D. (PRESIDENT)
(310) 289-0249
Entity
Organization
Contact information
Practice address
8631 W. 3RD STREET, SUITE 1115E, LOS ANGELES, CA 90048-5923
(310) 289-0249
(310) 289-8179
Mailing address
8631 W. 3RD STREET, SUITE 1115E, LOS ANGELES, CA 90048-5923
(310) 289-0249
(310) 289-8179
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
G51926
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00G51926
—
CA
Enumeration date
10/08/2010
Last updated
10/08/2010
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