Organization Active NPI

Tiffany Dawn Wilson, M.D., Inc.

  • Family Medicine Physician
  • Irvine, CA
National Provider Identifier
1861595282
Registry record updated Feb 11, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
TIFFANY DAWN WILSON, M.D., INC.
Practice address
37 Creek Rd Ste 140
Irvine, CA 92604-4724
Phone
(949) 559-4480
Fax
(949) 262-7072
NPI assigned
Sep 7, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 11, 2026

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

Authorized official

Name
Dr. Tiffany D Wilson, MDNPI 1700877057
Title
Owner
Phone
(949) 559-4480

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
Family Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207Q00000X Primary

Addresses

Primary practice location

37 Creek Rd Ste 140
Irvine, CA 92604-4724

Mailing address

PO Box 1744
Suisun City, CA 94585-4744
Phone (657) 241-3600

Other identifiers 2

IdentifierTypeStateIssuer
CB280062OtherCAMEDICARE PTAN
DY3730OtherCAMEDICARE RAILROAD

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040415000824 CA Part B Supplier - Clinic/Group Practice 4688669146 Receives reassigned benefits from 1 practitioner
Practice locations: Irvine, CA

National Provider Directory

National Provider Directory
Tax ID family
Tiffany Dawn Wilson MD2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Locations

37 Creek Rd
Ste A140
Irvine, CA 92604

33 Creek Rd
Ste A140
Irvine, CA 92604

37 Creek Rd
Ste 140
Irvine, CA 92604
Phone (949) 559-4480

Practitioners & affiliated clinicians

Practitioners 1

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": "1157587200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1770768000000",
    "number": "1861595282",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1744",
            "city": "SUISUN CITY",
            "state": "CA",
            "postal_code": "945854744",
            "telephone_number": "657-241-3600",
            "fax_number": "657-241-7708"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "37 CREEK RD STE 140",
            "city": "IRVINE",
            "state": "CA",
            "postal_code": "926044724",
            "telephone_number": "949-559-4480",
            "fax_number": "949-262-7072"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TIFFANY DAWN WILSON, M.D., INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-07",
        "last_updated": "2026-02-11",
        "certification_date": "2026-02-11",
        "status": "A",
        "authorized_official_last_name": "WILSON",
        "authorized_official_first_name": "TIFFANY",
        "authorized_official_middle_name": "D",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "949-559-4480",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PTAN",
            "identifier": "CB280062",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE RAILROAD",
            "identifier": "DY3730",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Irvine, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 11, 2026; 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.