Harry Stone Wilters, SOIDC

Primary specialty

Independent Duty CorpsmanTaxonomy code 1710I1002X

Practice address

26033 Cape Dr
Laguna Niguel, CA 92677-0914

Phone

(251) 504-7536

NPI assigned

Jun 8, 2021

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

Other identifiers 1

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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

{
    "created_epoch": "1623110400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1623110400000",
    "number": "1336716364",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 555341",
            "city": "CAMP PENDLETON",
            "state": "CA",
            "postal_code": "920555341",
            "telephone_number": "760-725-6579"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "26033 CAPE DR",
            "city": "LAGUNA NIGUEL",
            "state": "CA",
            "postal_code": "926770914",
            "telephone_number": "251-504-7536"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILTERS",
        "first_name": "HARRY",
        "middle_name": "STONE",
        "credential": "SOIDC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-06-08",
        "last_updated": "2021-06-08",
        "certification_date": "2021-06-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1710I1002X",
            "taxonomy_group": "",
            "desc": "Military Health Care Provider, Independent Duty Corpsman",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DODID",
            "identifier": "1453970546",
            "state": null
        }
    ],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "harry.s.wilters.mil@socom.mil",
            "affiliation": "N",
            "endpointDescription": "work email",
            "address_1": "26033 Cape Dr",
            "city": "Laguna Niguel",
            "state": "CA",
            "country_code": "US",
            "postal_code": "926770914",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Harry L. White, DMD
• Dilusha Wijesinghe Gunaratne
• Elizabeth Williams
• Jennifer Willingham
• Luiza Helena Wilson, MA,OTR/L
• Daniel Winant, DPT, ATC, MS, CSCS
• Angela Winslow, OTR
• Jessica Rae Witzmann, PA
• Frederic Tak-Hwa Wong, L.AC.
• Craig Woo

• Independent Duty Corpsman in Laguna Niguel, CA
• Providers in Laguna Niguel, CA by specialty
• Independent Duty Corpsman in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 8, 2021; 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.