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General NPI Number Information
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NPI Number | 1427580240
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Entity Type | Organization
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Legal Business Name | SANDRA WILSON MD INC
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Dates
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Enumeration Date | 03/30/2017
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Last Update Date | 03/15/2024
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Provider Practice Location Address
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Address Line | 2030 VIBORG RD
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City | SOLVANG
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State | CA
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Zip | 93463-3219
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Country | US
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Telephone | 805-245-9010
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Fax | 805-686-9977
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Provider Business Mailing Address
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Address Line | PO BOX 509
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City | LOS OLIVOS
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State | CA
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Zip | 93441-0509
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Country | US
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Telephone | 805-245-9010
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Fax | 805-686-9977
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Authorized Official
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Title or Position | PRESIDENT
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Name | SANDRA WILSON
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Credential | MD
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Telephone | 805-245-9010
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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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