Wildwood Medical, a Medical Corp.

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

Legal business name

WILDWOOD MEDICAL, A MEDICAL CORP.

Practice address

11244 Pleasant Valley Rd
Penn Valley, CA 95946

Phone

(530) 432-4937

Fax

(530) 432-5261

NPI assigned

May 31, 2006

Organization subpart

No

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

Authorized official

Name

Ginny L. Backus

Title

Billing Clerk

Phone

(530) 477-6830

Specialties & licenses 1

Addresses

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Elizabeth Wobus, MD

  • Internal Medicine Physician
  • Penn Valley, CA
  • NPI 1770673493
  NPD (past)

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

{
    "created_epoch": "1149033600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1248825600000",
    "number": "1013964220",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11244 PLEASANT VALLEY RD",
            "city": "PENN VALLEY",
            "state": "CA",
            "postal_code": "95946",
            "telephone_number": "530-432-4937",
            "fax_number": "530-432-5261"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11244 PLEASANT VALLEY RD",
            "city": "PENN VALLEY",
            "state": "CA",
            "postal_code": "95946",
            "telephone_number": "530-432-4937",
            "fax_number": "530-432-5261"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WILDWOOD MEDICAL, A MEDICAL CORP.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-31",
        "last_updated": "2009-07-29",
        "status": "A",
        "authorized_official_last_name": "BACKUS",
        "authorized_official_first_name": "GINNY",
        "authorized_official_middle_name": "L.",
        "authorized_official_title_or_position": "BILLING CLERK",
        "authorized_official_telephone_number": "530-477-6830"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Meghann Vela
• Vital Health Ca Medical Group (Vital Health)
• Bailey E Walker, RDH
• Douglas Maurice Wells, RPH
• Western Sierra Medical Clinic, Inc. (Western Sierra Medical Clinic - Penn Valley)
• Wildwood Physical Therapy Inc
• Elizabeth Wobus, MD
• Christiane Wolters, M.D.

• Family Medicine Physician in Penn Valley, CA
• Providers in Penn Valley, CA by specialty
• Family Medicine Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 29, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.