MEDICARE: WILDFLOWER PEDIATRICS INC

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	208000000X	Pediatrics Physician

General Provider Information

NPI Number	:	1437098621
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	WILDFLOWER PEDIATRICS INC

Provider Business Mailing Address
First Line	:	19 ILAHEE LN
Second Line	:
City	:	CHICO
State	:	CA
Zip	:	95973-7205
Country	:	US
Telephone Number	:	530-898-1201
Fax Number	:	530-898-1204

Provider Business Practice Location Address
First Line	:	19 ILAHEE LN
Second Line	:
City	:	CHICO
State	:	CA
Zip	:	95973-7205
Country	:	US
Telephone Number	:	530-570-0377
Fax Number	:	530-898-1204

Authorized Official
Title or Position	:	PRESIDENT
Name	:	REBECCA BOENING
Credential	:	MD
Telephone Number	:	530-898-1201

Provider Enumeration Date	:	03/25/2026
Last Update Date	:	03/30/2026

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