Individual
MATTHEW D WILSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DPM
Contact information
Practice address
5555 RESERVOIR DR STE 104, SAN DIEGO, CA 92120-5198
(619) 286-9480
(619) 286-4568
Mailing address
5555 RESERVOIR DR STE 104, SAN DIEGO, CA 92120-5198
(619) 286-9480
(619) 286-4568
Taxonomy
Speciality
Code
Description
License number
State
213E00000X
Podiatrist
Primary
E5700
CA
213ES0103X
Foot & Ankle Surgery Podiatrist
00000
AZ
390200000X
Student in an Organized Health Care Education/Training Program
—
OH
Other
Enumeration date
04/04/2016
Last updated
03/12/2026
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