Individual
DR. CHARLES LEONARD WILSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
11721 TELEGRAPH RD, SANTA FE SPRINGS, CA 90670-3674
(562) 949-8455
(562) 949-4807
Mailing address
PO BOX 3210, LA HABRA, CA 90632-3210
(714) 870-8748
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
A18240
CA
Other
Enumeration date
02/06/2007
Last updated
07/08/2007
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