Organization
WILSON MEDICAL GROUP, PC
Active
Organization
WILSON MEDICAL GROUP, PC
Active
Other names
South Bay Behavioral Medicine
Organization subpart
No
Provider details
NPI number
Authorized official
DR. CARA WILSON MD (PRESIDENT)
(424) 392-6060
Entity
Organization
Contact information
Practice address
4305 TORRANCE BLVD STE 508, TORRANCE, CA 90503-4493
(424) 392-6060
(424) 392-6062
Mailing address
322 CULVER BLVD STE 171, PLAYA DEL REY, CA 90293-7704
(424) 392-6060
(424) 392-6062
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
—
—
261QM0850X
Adult Mental Health Clinic/Center
—
—
261QM1300X
Multi-Specialty Clinic/Center
Primary
—
—
Other
Enumeration date
01/23/2020
Last updated
01/23/2020
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