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DR. MILLICENT ELAINE WILSON MD

>> Emergency Medicine >> Allopathic & Osteopathic Physicians

Registrant NPI Number: 1558879296

Individual Registrant:
DR. MILLICENT ELAINE WILSON MD
Gender: F
Sole Proprietor

Location and contact information for practice:
245 S FETTERLY AVE  EAST LOS ANGELES, CA 90022-1605 US
Tel: 323-362-1400  Fax: 323-362-1373

Contact information for business:
10100 PIONEER BLVD STE 200  SANTA FE SPRINGS, CA 90670-8299 US
Tel: 562-347-1648  Fax: --

Registration Information:
NPI: 1558879296
Entity Type: Individual

Specialty information:

PrimaryCodeCategory/DescriptionStateLicense Number
Y207P00000XAllopathic & Osteopathic Physicians
Emergency Medicine
CAG079177

Legacy codes, insurance codes and state license numbers:

IssuerNumberStateType




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