Individual
MISS WANDA ALTHEA WILBURN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
16000 APPLE VALLEY RD, SUITE C-3, APPLE VALLEY, CA 92307-7814
(760) 946-3806
(760) 946-3809
Mailing address
19050 LENCA RD, APPLE VALLEY, CA 92307-4709
(760) 242-4406
Taxonomy
Speciality
Code
Description
License number
State
207VX0000X
Obstetrics Physician
Primary
A84253
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00A842530
—
CA
Enumeration date
11/28/2006
Last updated
02/29/2024
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