Aeron D. Wickes, M.D.

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

G55311 Issued in CA

Practice address

12650 Sabre Springs Pkwy
#204
San Diego, CA 92128-4114

Phone

(858) 679-9262

Fax

(858) 679-1885

NPI assigned

May 1, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

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

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

{
    "created_epoch": "1146441600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1607644800000",
    "number": "1306804380",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "332 S JUNIPER ST STE 100",
            "city": "ESCONDIDO",
            "state": "CA",
            "postal_code": "920254941",
            "telephone_number": "760-291-6621",
            "fax_number": "760-737-3430"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12650 SABRE SPRINGS PKWY",
            "address_2": "#204",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921284114",
            "telephone_number": "858-679-9262",
            "fax_number": "858-679-1885"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WICKES",
        "first_name": "AERON",
        "middle_name": "D.",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-01",
        "last_updated": "2020-12-11",
        "certification_date": "2020-12-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "G55311",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "aeron.wickesmd.p1@direct.graybill.nextgenshare.com",
            "affiliation": "N",
            "address_1": "12650 Sabre Springs Pkwy",
            "address_2": "#204",
            "city": "San Diego",
            "state": "CA",
            "country_code": "US",
            "postal_code": "921284114",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Jenna Wick, MD
• Bryan Wickens, MA
• Kandy A Wicker-Constantino
• Kara Wickeraad, DPT, ATC
• Melissa Wickerd
• Madison O'Hara Wickham
• Shea Breenan Wickland, M.D.
• Brynne Wicklund
• Sheree Wicklund
• Austin Michele Wicks, MD

• Family Medicine Physician in San Diego, CA
• Providers in San Diego, 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 Dec 11, 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.