Organization Active NPI

Sandra Wilson MD Inc

  • Internal Medicine Physician
  • Solvang, CA
National Provider Identifier
1427580240
Registry record updated Mar 15, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
Legal business name
SANDRA WILSON MD INC
Practice address
2030 Viborg Rd
Solvang, CA 93463-3219
Phone
(805) 245-9010
Fax
(805) 686-9977
NPI assigned
Mar 30, 2017
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 15, 2024

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

Authorized official

Name
Sandra Wilson, MDNPI 1457440638
Title
President
Phone
(805) 245-9010

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207R00000X Primary

Addresses

Primary practice location

2030 Viborg Rd
Solvang, CA 93463-3219

Mailing address

PO Box 509
Los Olivos, CA 93441-0509
Phone (805) 245-9010

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20170510002221 CA Part B Supplier - Clinic/Group Practice 1850678335 Receives reassigned benefits from 2 practitioners
Practice locations: Solvang, CA

National Provider Directory

National Provider Directory

Locations

2030 Viborg Rd
Solvang, CA 93463
Phone (805) 245-9010

2030 Viborg Rd
Ste 110
Solvang, CA 93463
Phone (805) 691-9712

2030 Viborg Rd
Ste 102
Solvang, CA 93463
Phone (805) 245-9010

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1490832000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1710460800000",
    "number": "1427580240",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 509",
            "city": "LOS OLIVOS",
            "state": "CA",
            "postal_code": "934410509",
            "telephone_number": "805-245-9010",
            "fax_number": "805-686-9977"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2030 VIBORG RD",
            "city": "SOLVANG",
            "state": "CA",
            "postal_code": "934633219",
            "telephone_number": "805-245-9010",
            "fax_number": "805-686-9977"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SANDRA WILSON MD INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-03-30",
        "last_updated": "2024-03-15",
        "certification_date": "2024-03-15",
        "status": "A",
        "authorized_official_last_name": "WILSON",
        "authorized_official_first_name": "SANDRA",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "805-245-9010",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Solvang, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 15, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.