Healthcare Provider Details

I. General information

NPI: 1033118047
Provider Name (Legal Business Name): GEORGE L WILKINSON M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: X

II. Dates (important events)

Enumeration Date: 07/20/2005
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

702 MARSHALL ST SUITE 410
REDWOOD CITY CA
94063-1829
US

IV. Provider business mailing address

702 MARSHALL ST SUITE 410
REDWOOD CITY CA
94063-1829
US

V. Phone/Fax

Practice location:
  • Phone: 650-367-0472
  • Fax: 650-367-0709
Mailing address:
  • Phone: 650-367-0472
  • Fax: 650-367-0709

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2084F0202X
TaxonomyForensic Psychiatry Physician
License NumberG21294
License Number StateCA
# 2
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License NumberG21294
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: