Healthcare Provider Details

I. General information

NPI: 1164637872
Provider Name (Legal Business Name): APRIL ENGLE WILSON M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: MISS APRIL MELISSA ENGLE

II. Dates (important events)

Enumeration Date: 05/14/2007
Last Update Date: 12/22/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

24785 STEWART ST EVANS HALL SUITE 111
LOMA LINDA CA
92350-1721
US

IV. Provider business mailing address

24785 STEWART ST EVANS HALL SUITE 204
LOMA LINDA CA
92350-1721
US

V. Phone/Fax

Practice location:
  • Phone: 909-558-8770
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2083P0901X
TaxonomyPublic Health & General Preventive Medicine Physician
License NumberA101649
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: