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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