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Individual

LUKAS MAXWELL WILSON

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man

Contact information

Practice address
35114 MOUNTAIN VIEW ST, YUCAIPA, CA 92399-4725
(909) 708-7556
Mailing address
35114 MOUNTAIN VIEW ST, YUCAIPA, CA 92399-4725
(909) 708-7556

Taxonomy

Speciality
Code
Description
License number
State
146M00000X
Intermediate Emergency Medical Technician
Primary
5251-2674-5073
CA

Other

Enumeration date
08/25/2025
Last updated
08/25/2025
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