Individual provider Active NPI

Isabel Elodia Wilhelm, PA-C

  • Physician Assistant
  • Walnut, CA
National Provider Identifier
1013368315
Registry record updated Jul 20, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
53549 Issued in CA
Practice address
19524 Avenida del Campo
Walnut, CA 91789-1607
Phone
(909) 731-4761
NPI assigned
Jun 28, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 20, 2023

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 53549 CA Primary

Addresses

Primary practice location

19524 Avenida del Campo
Walnut, CA 91789-1607

Mailing address

19524 Avenida del Campo
Walnut, CA 91789-1607
Phone (909) 731-4761

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20170104001609 CA Practitioner - Physician Assistant 5193006211 Reassigns benefits to 3 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
53549CAMDOral and Maxillofacial Surgery (Dentist)

Practice roles

OrganizationSpecialtyStatusNew patients
Providence Facey Medical Foundation CurrentSince Aug 20, 2020 Accepting new patients
Providence Facey Medical Foundation CurrentSince Aug 20, 2020 Accepting new patients
Torrance Health Association Inc CurrentSince Jun 1, 2024 Accepting new patients
Carbon Health Primary Care of California PC PastSince Jul 20, 2025 Accepting new patients

Locations

19950 Rinaldi St
Ste 103
Porter Ranch, CA 91326
Phone (818) 403-2400

514 N Prospect Ave
Fl 4
Redondo Beach, CA 90277
Phone (310) 750-3300

23326 Hawthorne Blvd
Ste 200
Torrance, CA 90505
Phone (310) 257-7205

Organizations & group practices 5

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1467072000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1689811200000",
    "number": "1013368315",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "19524 AVENIDA DEL CAMPO",
            "city": "WALNUT",
            "state": "CA",
            "postal_code": "917891607",
            "telephone_number": "909-731-4761"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "19524 AVENIDA DEL CAMPO",
            "city": "WALNUT",
            "state": "CA",
            "postal_code": "917891607",
            "telephone_number": "909-731-4761"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILHELM",
        "first_name": "ISABEL",
        "middle_name": "ELODIA",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-06-28",
        "last_updated": "2023-07-20",
        "certification_date": "2023-07-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CA",
            "license": "53549",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Walnut, CA

Sources for this page

Verify at the official NPI Registry.