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General NPI Number Information
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NPI Number | 1780601252
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Entity Type | Individual
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Provider Name | BRETT WILSON II M.D.
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Gender | Male
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Dates
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Enumeration Date | 07/17/2006
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Last Update Date | 04/01/2010
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Provider Practice Location Address
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Address Line | 300 W PUEBLO ST
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City | SANTA BARBARA
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State | CA
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Zip | 93105-4311
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Country | US
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Telephone | 805-682-7111
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Fax | 805-569-8368
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Provider Business Mailing Address
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Address Line | PO BOX 10040
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City | WESTMINSTER
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State | CA
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Zip | 92685-0040
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Country | US
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Telephone | 562-809-3528
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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 | 207P00000X
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Taxonomy Name | Emergency Medicine Physician
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License Number | MD.026108
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License Number State | LA
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Taxonomy #2
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Taxonomy Code | 207P00000X
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Taxonomy Name | Emergency Medicine Physician
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License Number | A97199
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License Number State | CA
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