Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.
DR. THADDEUS EARL WILSON, M.D.
Active Sole ProprietorDR. THADDEUS EARL WILSON, M.D. is a Pediatric Rehabilitation Medicine healthcare provider located in LOMA LINDA, California. NPI 1184839896 is currently active in the NPPES registry. Verify at CMS.
Pediatric Rehabilitation Medicine · LOMA LINDA, CA
Registration Details
- NPI Number
- 1184839896
- Provider Type
- Individual
- Gender
- Male
- NPI Issued
- May 14, 2007 (19.289875726627 yrs)
- Last Updated
- Aug 15, 2014
- License
-
A102261 (CA)
- Sole Proprietor
- Yes
Practice Information
- Address
-
11406 LOMA LINDA DRPHYSICAL MEDICINE AND REHABILITATIONLOMA LINDA, CA, 923543711Browse CA providers · Browse ZIP 92354
- Phone
- 9095586275
- Fax
- 9095586212
- Primary Specialty
-
Pediatric Rehabilitation Medicine
2081P0010X
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.