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General NPI Number Information
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NPI Number | 1508286089
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Entity Type | Individual
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Provider Name | PETER WILTON
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Gender | Male
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Dates
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Enumeration Date | 04/23/2014
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Last Update Date | 09/09/2020
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Provider Practice Location Address
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Address Line | 15325 FAIRFIELD RANCH RD STE 150
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City | CHINO HILLS
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State | CA
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Zip | 91709-8842
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Country | US
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Telephone | 909-557-1668
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Fax |
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Provider Business Mailing Address
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Address Line | 15325 FAIRFIELD RANCH RD STE 150
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City | CHINO HILLS
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State | CA
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Zip | 91709-8842
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Country | US
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Telephone | 909-557-1668
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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 | 207XS0106X
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Taxonomy Name | Orthopaedic Hand Surgery Physician
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License Number | A137884
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License Number State | CA
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