Active NPI
Aaron Wickard
- General Practice Physician
- Coronado, CA
National Provider Identifier
1134879372
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Physician
- License
- 010278960
- Practice address
- 3632 Tulagi Road
Coronado, CA 92118 - Phone
- (619) 545-7413
- NPI assigned
- Mar 28, 2022
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Physician | 208D00000X | 010278960 | VA | Primary |
Addresses
Primary practice location
3632 Tulagi Road
Coronado, CA 92118
Mailing address
34800 Bob Wilson Dr # DT
San Diego, CA 92134-1098
Other practice location 1
34800 Bob Wilson Dr
San Diego, CA 92134-1098
Phone (619) 532-7599
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1648425600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1782864000000",
"number": "1134879372",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "34800 BOB WILSON DR # DT",
"city": "SAN DIEGO",
"state": "CA",
"postal_code": "921341098"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3632 TULAGI ROAD",
"city": "CORONADO",
"state": "CA",
"postal_code": "92118",
"telephone_number": "619-545-7413"
}
],
"practiceLocations": [
{
"address_1": "34800 Bob Wilson Dr",
"address_purpose": "LOCATION",
"city": "San Diego",
"state": "CA",
"postal_code": "921341098",
"country_code": "US",
"telephone_number": "619-532-7599",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "WICKARD",
"first_name": "AARON",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2022-03-28",
"last_updated": "2026-07-01",
"certification_date": "2026-07-01",
"status": "A"
},
"taxonomies": [
{
"code": "208D00000X",
"taxonomy_group": "",
"desc": "General Practice",
"state": "VA",
"license": "010278960",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Coronado, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 1, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.