Individual
MARY L. WILSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
4760 W SUNSET BLVD, LOS ANGELES, CA 90027-6063
(323) 783-4011
Mailing address
4760 W SUNSET BLVD, LOS ANGELES, CA 90027-6063
(323) 783-4011
Taxonomy
Speciality
Code
Description
License number
State
2080N0001X
Neonatal-Perinatal Medicine Physician
Primary
G43430
CA
Other
Enumeration date
12/08/2006
Last updated
09/23/2008
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