=====================================================
General NPI Number Information
=====================================================
NPI Number | 1073171930
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | MOLLY LINDEN WILKERSON MD
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 06/04/2019
-----------------------------------------------------
Last Update Date | 07/31/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 8800 FOOTHILL BLVD
-----------------------------------------------------
City | SUNLAND
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 91040-1925
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 888-499-9303
-----------------------------------------------------
Fax | 323-853-6927
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 8800 FOOTHILL BLVD
-----------------------------------------------------
City | SUNLAND
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 91040-1925
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 888-499-9303
-----------------------------------------------------
Fax | 323-853-6927
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 207Q00000X
-----------------------------------------------------
Taxonomy Name | Family Medicine Physician
-----------------------------------------------------
License Number | A179608
-----------------------------------------------------
License Number State | CA
-----------------------------------------------------