Wilson, Carl

Wilson, Carl is an individual health care provider with primary practice located at 435 Doyle Park Dr , Santa Rosa CA 95405-4515. He recently has only one registered license in Allopathic & Osteopathic Physicians / Nephrology, which is considered as his primary health care specialty. Wilson, Carl can be contacted via phone (707) 527-9510.

Contact Information

Primary practice address
435 Doyle Park Dr Santa Rosa CA 95405-4515
Phone: (707) 527-9510
Fax: (707) 527-1306
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Nephrology 207RN0300X G44318 California

Profile Details

NPI number 1033110465
LBN Legal business name Wilson, Carl
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Aug 9th, 2005
Last updated Jul 25th, 2017 - about 9 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1033110465 NPPES
California MEDICAID 00G443180

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