Active NPI
Darrell Timothy Wilkins, P.A.
- Medical Physician Assistant
- Corona, CA
National Provider Identifier
1740463165
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Medical Physician Assistant
- License
- PA16458
- Practice address
- 341 Magnolia Ave
Suite 101
Corona, CA 92879-3330 - Phone
- (951) 735-6060
- Fax
- (951) 735-4510
- NPI assigned
- Dec 7, 2007
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Medical Physician Assistant | 363AM0700X | PA16458 | CA | Primary |
Addresses
Primary practice location
341 Magnolia Ave
Suite 101
Corona, CA 92879-3330
Mailing address
341 Magnolia Ave
Suite 101
Corona, CA 92879-3330
Phone (951) 735-6060
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 16458 | CA | MD | Orthodontics and Dentofacial Orthopedic Dentist |
| PA16458 | CA | MD | Medical Physician Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1196985600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1678147200000",
"number": "1740463165",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "341 MAGNOLIA AVE",
"address_2": "SUITE 101",
"city": "CORONA",
"state": "CA",
"postal_code": "928793330",
"telephone_number": "951-735-6060",
"fax_number": "951-735-4510"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "341 MAGNOLIA AVE",
"address_2": "SUITE 101",
"city": "CORONA",
"state": "CA",
"postal_code": "928793330",
"telephone_number": "951-735-6060",
"fax_number": "951-735-4510"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WILKINS",
"first_name": "DARRELL",
"middle_name": "TIMOTHY",
"credential": "P.A.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2007-12-07",
"last_updated": "2023-03-07",
"status": "A"
},
"taxonomies": [
{
"code": "363AM0700X",
"taxonomy_group": "",
"desc": "Physician Assistant, Medical",
"state": "CA",
"license": "PA16458",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Corona, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 7, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.