Individual
BYRON ERIC WILSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
20055 LAKE CHABOT RD, #130, CASTRO VALLEY, CA 94546
(510) 888-0657
(510) 886-4532
Mailing address
5725 W LAS POSITAS BLVD, #100, PLEASANTON, CA 94588-4054
(925) 734-8130
(925) 225-0121
Taxonomy
Speciality
Code
Description
License number
State
207RH0000X
Hematology (Internal Medicine) Physician
G72444
CA
207RX0202X
Medical Oncology Physician
Primary
G72444
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00G724440
—
CA
01
—
900002477
RAILROAD MEDICARE
—
Enumeration date
07/05/2006
Last updated
08/21/2018
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