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General NPI Number Information
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NPI Number | 1881178358
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Entity Type | Organization
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Legal Business Name | ON SITE PHYSICIAN SERVICES, PC
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Dates
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Enumeration Date | 09/20/2018
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Last Update Date | 09/20/2018
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Provider Practice Location Address
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Address Line | 6131 TELEGRAPH ROAD
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City | COMMERCE
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State | CA
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Zip | 90040
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Country | US
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Telephone | 323-721-2100
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Fax | 815-759-5202
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Provider Business Mailing Address
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Address Line | 4805 PRIME PARKWAY PO BOX 550
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City | MCHENRY
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State | IL
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Zip | 60050
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Country | US
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Telephone | 815-363-9500
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Fax | 815-363-9696
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. BRIAN WILBUR
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Credential | M.D.
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Telephone | 213-840-3181
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number |
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License Number State |
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