Individual
LAURA ANN WILSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
505 S MAIN ST STE 525, ORANGE, CA 92868-4553
(714) 456-5631
(714) 285-0389
Mailing address
33601 WINDJAMMER DR, DANA POINT, CA 92629-4469
(714) 742-3245
Taxonomy
Speciality
Code
Description
License number
State
207SG0201X
Clinical Genetics (M.D.) Physician
Primary
A165832
CA
207SG0207X
Medical Biochemical Genetics
A165832
CA
Other
Enumeration date
03/19/2018
Last updated
06/06/2024
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