| Mark D Wilson, Md Inc | |
|
400 W Pueblo St Santa Barbara CA 93105-4353 | |
| (805) 682-7111 | |
| Not Available |
| Full Name | Mark D Wilson, Md Inc |
|---|---|
| Speciality | Internal Medicine |
| Location | 400 W Pueblo St, Santa Barbara, California |
| Authorized Official Name and Position | Mark Daniel Wilson (PRESIDENT) |
| Authorized Official Contact | 8056371120 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Mark D Wilson, Md Inc 780 La Buena Tierra Santa Barbara CA 93111-1705 Ph: (805) 637-1120 | Mark D Wilson, Md Inc 400 W Pueblo St Santa Barbara CA 93105-4353 Ph: (805) 682-7111 |
| NPI Number | 1710470703 |
|---|---|
| Provider Enumeration Date | 06/13/2018 |
| Last Update Date | 06/13/2018 |
| Medicare PECOS PAC ID | 4981957537 |
|---|---|
| Medicare Enrollment ID | O20181029000666 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1710470703 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207RE0101X | Internal Medicine - Endocrinology, Diabetes & Metabolism | A76869 (California) | Primary |
| Provider Name | Mark D Wilson |
|---|---|
| Provider Type | Practitioner - Endocrinology |
| Provider Identifiers | NPI Number: 1902819782 PECOS PAC ID: 0547299265 Enrollment ID: I20050811000917 |
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