Stephen M Wilson, M.D.

Primary specialty

Surgery PhysicianTaxonomy code 208600000X

License

G23030 Issued in CA

Practice address

1950 Sunnycrest Dr
Suite 2600
Fullerton, CA 92835-3638

Phone

(714) 446-5260

Fax

(714) 446-5265

NPI assigned

Nov 13, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

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.

• North County Surgical Medical Group, Inc

  • Specialist
  • Fullerton, CA
  • NPI 1881630226
  NPD (past)

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

{
    "created_epoch": "1163376000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1603238400000",
    "number": "1245301084",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1950 SUNNY CREST DR STE 2600",
            "city": "FULLERTON",
            "state": "CA",
            "postal_code": "928353644",
            "telephone_number": "714-446-5260"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1950 SUNNYCREST DR",
            "address_2": "SUITE 2600",
            "city": "FULLERTON",
            "state": "CA",
            "postal_code": "928353638",
            "telephone_number": "714-446-5260",
            "fax_number": "714-446-5265"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILSON",
        "first_name": "STEPHEN",
        "middle_name": "M",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-11-13",
        "last_updated": "2020-10-21",
        "certification_date": "2020-10-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "CA",
            "license": "G23030",
            "primary": false
        },
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "CA",
            "license": "G23030",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "stephenwilson@sjhhandhmg.allscriptsdirect.net",
            "affiliation": "N",
            "address_1": "1950 Sunnycrest Dr",
            "address_2": "Suite 2600",
            "city": "Fullerton",
            "state": "CA",
            "country_code": "US",
            "postal_code": "928353638",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Christy Black Willman, RN
• Daniela Wilmes, EDUCATION SPECIALIST
• Alexandra Wilson, LCSW
• Ashalyn Michelle Wilson
• Daniel Douglas Wilson, DDS
• Windsor Gardens Healthcare Center of Fullerton, LLC
• Willem Winkelman, ATC, EMT-B
• Karen Marie Winkle, SLP
• Winnie L. Young, D.D.S., Inc,
• Sydney T Winstead

• Surgery Physician in Fullerton, CA
• Providers in Fullerton, CA by specialty
• Surgery Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 21, 2020; 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.