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General NPI Number Information
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NPI Number | 1366303174
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Entity Type | Organization
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Legal Business Name | NORTH STATE MEDICAL PRIMARY CARE, INC.
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Dates
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Enumeration Date | 11/20/2025
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Last Update Date | 02/17/2026
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Provider Practice Location Address
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Address Line | 274 COHASSET RD STE 110
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City | CHICO
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State | CA
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Zip | 95926-2236
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Country | US
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Telephone | 530-896-7455
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Fax | 530-896-1832
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Provider Business Mailing Address
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Address Line | 140 AMBER GROVE DR STE 143
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City | CHICO
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State | CA
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Zip | 95973-5887
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Country | US
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Telephone | 530-896-7455
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Fax | 530-896-1832
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Authorized Official
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Title or Position | CEO/CFO
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Name | EDWARD T WILSON
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Credential | D.O.
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Telephone | 530-896-7455
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number |
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License Number State |
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