Healthcare Provider Details

I. General information

NPI: 1164777587
Provider Name (Legal Business Name): LINDSEY WAKEFIELD WILKE D.P.M.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/23/2012
Last Update Date: 09/18/2026
Certification Date: 09/18/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

16870 W BERNARDO DR STE 202
SAN DIEGO CA
92127-1671
US

IV. Provider business mailing address

16870 W BERNARDO DR STE 202
SAN DIEGO CA
92127-1671
US

V. Phone/Fax

Practice location:
  • Phone: 760-875-2626
  • Fax: 760-867-2530
Mailing address:
  • Phone: 760-875-2626
  • Fax: 760-867-2530

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code213ES0103X
TaxonomyFoot & Ankle Surgery Podiatrist
License NumberE5161
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: