Active NPI
Benjamin Stuart Wilbur, M.D.
- General Practice Physician
- Los Angeles, CA
National Provider Identifier
1790758613
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Physician
- License
- A92956
- Practice address
- 1155 North Vermont Ave
Suite 200
Los Angeles, CA 90029-1728 - Phone
- (323) 664-1814
- Fax
- (323) 663-1723
- NPI assigned
- Feb 10, 2006
- 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 |
|---|---|---|---|---|
| General Practice Physician | 208D00000X | A92956 | CA | Primary |
Addresses
Primary practice location
1155 North Vermont Ave
Suite 200
Los Angeles, CA 90029-1728
Mailing address
12762 Limonite Ave
#3E-235
Eastvale, CA 92880-4208
Phone (951) 427-0001
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)
- Not enrolled
- HHS exclusion list flag
- CMS’s directory marks this NPI as on an HHS exclusion list; no matching OIG record was found.
- Credentials
- Doctor of Medicine
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Ontario Family Medical Center Inc | Past | Accepting new patients | |
| Santa Ana Prohealth Medical Clinic Inc | Past | Accepting new patients | |
| Hagop Blikian Chiropractic Inc | Past | Accepting new patients | |
| Blikian Chiropractic and Acupuncture Inc | Past | Accepting new patients |
Organizations & group practices 4
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- Family Medicine Physician
- Ontario, CA
- NPI 1447561162
-
- Chiropractor
- Glendale, CA
- NPI 1790235406
-
- Chiropractor
- Glendale, CA
- NPI 1740556430
-
- Clinic/Center
- Santa Ana, CA
- NPI 1619153111
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1139529600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1347494400000",
"number": "1790758613",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "12762 LIMONITE AVE",
"address_2": "#3E-235",
"city": "EASTVALE",
"state": "CA",
"postal_code": "928804208",
"telephone_number": "951-427-0001",
"fax_number": "909-483-1063"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1155 NORTH VERMONT AVE",
"address_2": "SUITE 200",
"city": "LOS ANGELES",
"state": "CA",
"postal_code": "900291728",
"telephone_number": "323-664-1814",
"fax_number": "323-663-1723"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WILBUR",
"first_name": "BENJAMIN",
"middle_name": "STUART",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-02-10",
"last_updated": "2012-09-13",
"status": "A"
},
"taxonomies": [
{
"code": "208D00000X",
"taxonomy_group": "",
"desc": "General Practice",
"state": "CA",
"license": "A92956",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Los Angeles, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 13, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.