Robert L Wilson M D Inc

Primary specialty

General Practice PhysicianTaxonomy code 208D00000X

License

A23286 Issued in CA

Legal business name

ROBERT L WILSON M D INC

Practice address

2815 W Sunset Blvd
205
Los Angeles, CA 90026-2167

Phone

(213) 484-1271

Fax

(213) 484-1217

NPI assigned

May 12, 2009

Organization subpart

No

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

Authorized official

Name

Dr. Robert L Wilson, M.D.

Title

Ceo/ President

Phone

(213) 484-1271

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1242086400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1242086400000",
    "number": "1346474889",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2815 W SUNSET BLVD",
            "address_2": "205",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900262167",
            "telephone_number": "213-484-1271",
            "fax_number": "213-484-1217"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2815 W SUNSET BLVD",
            "address_2": "205",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900262167",
            "telephone_number": "213-484-1271",
            "fax_number": "213-484-1217"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ROBERT L WILSON M D INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-05-12",
        "last_updated": "2009-05-12",
        "status": "A",
        "authorized_official_last_name": "WILSON",
        "authorized_official_first_name": "ROBERT",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "CEO/ PRESIDENT",
        "authorized_official_telephone_number": "213-484-1271",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "General Practice",
            "state": "CA",
            "license": "A23286",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• General Practice Physician in Los Angeles, CA
• Providers in Los Angeles, CA by specialty
• General Practice Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 12, 2009; 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.