Stephen Charles Wilson, MD

Primary specialty

Surgery PhysicianTaxonomy code 208600000X

License

G27579 Issued in CA

Practice address

130 Cedar Rd # 350
Vista, CA 92083-5102

Phone

(760) 806-5660

Fax

(760) 631-3435

NPI assigned

Jul 27, 2006

Last updated

Jun 17, 2009By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Scripps Health

  dba Scripps Medical Foundation

  • Family Medicine Physician
  • Vista, CA
  • NPI 1861477846

  Surgery

  NPD (past)

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

{
    "created_epoch": "1153958400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1245196800000",
    "number": "1902810914",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2201 MISSION AVE",
            "city": "OCEANSIDE",
            "state": "CA",
            "postal_code": "920542328",
            "telephone_number": "760-806-5660",
            "fax_number": "760-631-3435"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "130 CEDAR RD # 350",
            "city": "VISTA",
            "state": "CA",
            "postal_code": "920835102",
            "telephone_number": "760-806-5660",
            "fax_number": "760-631-3435"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILSON",
        "first_name": "STEPHEN",
        "middle_name": "CHARLES",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-27",
        "last_updated": "2009-06-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "CA",
            "license": "G27579",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00G275790",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Casper S Wilson
• Deisha Malones Wilson, D.O.
• Hannah Nicole Wilson
• Jennifer Ann Wilson, P.T., D.P.T
• Sidra Ann Wilson, LVN
• Mary Catherine Winchester, MA
• David Todd Wine, M.D.
• Wings Recovery Center
• Wings Recovery Center, Inc.
• Wings Recovery Center, Inc.

• Surgery Physician in Vista, CA
• Providers in Vista, CA by specialty
• Surgery Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 17, 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.