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General NPI Number Information
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NPI Number | 1063677300
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Entity Type | Individual
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Provider Name | JAMES PATRICK WILSON PHARMD, CDCES
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Gender | Male
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Dates
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Enumeration Date | 07/25/2008
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Last Update Date | 02/11/2025
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Provider Practice Location Address
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Address Line | 408 NUTMEG ST
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City | SAN DIEGO
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State | CA
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Zip | 92103-6214
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Country | US
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Telephone | 858-531-6935
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Fax |
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Provider Business Mailing Address
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Address Line | 2919 CALLE DE MALIBU
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City | ESCONDIDO
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State | CA
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Zip | 92029-5812
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Country | US
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Telephone | 858-531-6935
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1835P0018X
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Taxonomy Name | Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
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License Number | 53059
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License Number State | CA
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