MEDICARE: JULIUS WILSON

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	225700000X	Massage Therapist	82892	CA

General Provider Information

NPI Number	:	1184568289
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JULIUS WILSON

Provider Business Mailing Address
First Line	:	769 S PEACHTREE LN
Second Line	:
City	:	COVINA
State	:	CA
Zip	:	91723-3622
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	769 S PEACHTREE LN
Second Line	:
City	:	COVINA
State	:	CA
Zip	:	91723-3622
Country	:	US
Telephone Number	:	310-292-5112
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/17/2026
Last Update Date	:	04/17/2026

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Directions to “ JULIUS WILSON ” Practice Location

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