Individual
CORY M WILSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
27716 WILDERNESS PL, CASTAIC, CA 91384-4117
(661) 200-3581
(661) 200-3581
Mailing address
27716 WILDERNESS PL, CASTAIC, CA 91384-4117
(661) 200-3581
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
22843
NE
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
47042628500
—
NE
Enumeration date
02/14/2006
Last updated
09/26/2023
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