Individual
DR. WILBERT FORTSON JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
9300 VALLEY CHILDRENS PL, MADERA, CA 93636-8761
(559) 353-5700
Mailing address
9300 VALLEY CHILDRENS PL, MADERA, CA 93636-8761
Taxonomy
Speciality
Code
Description
License number
State
207VM0101X
Maternal & Fetal Medicine Physician
057459
GA
207VM0101X
Maternal & Fetal Medicine Physician
Primary
A74703
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1942381223
—
CA
Enumeration date
10/17/2006
Last updated
05/13/2020
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