Individual provider Active NPI

Sone-Seere A Wilson, MD

  • Emergency Medicine Physician
  • West Covina, CA
National Provider Identifier
1194772525
Registry record updated May 1, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
G59162 Issued in CA
Practice address
1115 S Sunset Ave
West Covina, CA 91790-3940
Phone
(626) 814-2434
NPI assigned
May 30, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 1, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X G59162 CA Primary

Addresses

Primary practice location

1115 S Sunset Ave
West Covina, CA 91790-3940

Mailing address

263 Ravenna Dr
Long Beach, CA 90803-3613
Phone (562) 754-0703

Other identifiers 1

IdentifierTypeStateIssuer
00G519620MedicaidCA

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20051007000907 CA Practitioner - Emergency Medicine 6608891767 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
59162CAMDPediatric Dentist

Practice roles

OrganizationSpecialtyStatusNew patients
Orange County Emergency Medical Associates, Inc. Emergency Medicine CurrentSince Oct 1, 2012 Accepting new patients
Healthcare Partners Affiliates Medical Group CurrentSince Nov 28, 2016 Accepting new patients
Healthcare Partners Affiliates Medical Group CurrentSince Nov 28, 2016 Accepting new patients
Max Franklin Lebow, a Medical Corporation Emergency Medicine Past Accepting new patients
Centinela Freeman Emergency Medical Associates Emergency Medicine Past Accepting new patients

Locations

1236 N Magnolia Ave
Anaheim, CA 92801
Phone (714) 995-1000

824 E Carson St
Ste 104
Carson, CA 90745
Phone (310) 830-9706

210 W San Bernardino Rd
Covina, CA 91723
Phone (626) 858-8580

250 S Grand Ave
Glendora, CA 91741
Phone (626) 857-3118

7901 Walker St
La Palma, CA 90623
Phone (562) 424-2900

15031 Rinaldi St
San Fernando, CA 91345
Phone (818) 365-8051

1115 S Sunset Ave
West Covina, CA 91790
Phone (626) 814-2434

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": "1148947200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1241136000000",
    "number": "1194772525",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "263 RAVENNA DR",
            "city": "LONG BEACH",
            "state": "CA",
            "postal_code": "908033613",
            "telephone_number": "562-754-0703"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1115 S SUNSET AVE",
            "city": "WEST COVINA",
            "state": "CA",
            "postal_code": "917903940",
            "telephone_number": "626-814-2434"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILSON",
        "first_name": "SONE-SEERE",
        "middle_name": "A",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-05-30",
        "last_updated": "2009-05-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "CA",
            "license": "G59162",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00G519620",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in West Covina, CA

Sources for this page

Verify at the official NPI Registry.