DR. MICHAEL BRYAN WILSON (NPI# 1376779306) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1376779306 |
| Entity Type | Individual |
| Full Name | DR. MICHAEL BRYAN WILSON |
| Credential | M.D. |
| Practice Address |
480 4th Ave Ste 202 Chula Vista CA 91910-4412 |
| Practice Telephone | 6194273361 |
| Practice Fax Number | 6198270539 |
| Mailing Telephone | 6194273361 |
| Mailing Fax Number | 6198270539 |
| Enumeration Date | 2009-06-04 |
| Last Update Date | 2014-09-29 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207Q00000X | Family Medicine | A107901 | CA | Allopathic & Osteopathic Physicians |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1386203537 | Michael John Wilson | Clinical Neuropsychologist | 9301 Madison St Rm 369, Crown Point, IN 46307-7745 | 2019-06-11 |
| 1982268017 | Michael Donavan Wilson | Counselor | 200 North Lewis, Waukegan, IL 60087 | 2019-04-24 |
| 1891201604 | Michael Paul Wilson | Technician/Technologist | 324 Garden Rd, Springfield, PA 19064-3505 | 2017-12-18 |
| 1659897536 | Michael Wilson | Driver | 1628 Bucktown Dr, Danville, VA 24543 | 2017-08-22 |
| 1386096501 | Michael Wilson | Home Health | 596 North Hawkins Ave, Akron, OH 44313 | 2016-07-12 |
| 1164895728 | Michael Wilson | Counselor | 3027 Pleasant Grv, Bossier City, LA 71111-5758 | 2015-11-04 |
| 1013384379 | Michael Wilson | Counselor | 7110 Sw Fir Loop Ste 220, Tigard, OR 97223 | 2015-08-21 |
| 1467828350 | Michael Wilson | Social Worker | 30500 Southfield Road Apt. 200, Michael Wilson, Southfield, MI 48076 | 2015-08-14 |
| 1356723803 | Michael Wilson II | Home Health Aide | 348 Wilson Ave, Port Clinton, OH 43452-1740 | 2015-06-22 |
| 1467641399 | Michael C. Wilson | Developmental Therapist | 820 E 38th Pl Unit 1, Chicago, IL 60653-1969 | 2007-10-16 |
| Street Address |
480 4TH AVE STE 202 |
| City | CHULA VISTA |
| State | CA |
| Zip Code | 91910-4412 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1356335731 | Ovidiu Alb | Family Medicine | 480 4th Ave Ste 202, Chula Vista, CA 91910-4412 | 2005-08-31 |
| 1720421076 | Maurellen Batangan Rabago | Family Medicine | 480 4th Ave Ste 202, Chula Vista, CA 91910-4412 | 2013-04-16 |
| 1447540083 | Carla Takahashi Stillwell | Family Medicine | 480 4th Ave Ste 202, Chula Vista, CA 91910-4412 | 2011-04-16 |
| 1578641874 | Simona Daniela Alb | Family Medicine | 480 4th Ave Ste 202, Chula Vista, CA 91910-4412 | 2006-11-02 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1477194264 | Joshua Maurice Hayden | Dental Hygienist | 678 Thrid Ave, Chula Vista, CA 91910 | 2019-10-02 |
| 1255980504 | Samantha Bernaldo | Dental Hygienist | 668 Third Ave, Chula Vista, CA 91910 | 2019-09-10 |
| 1073179529 | Roshni Kakaiya | Student in an Organized Health Care Education/Training Program | 435 H Street, Cv112, Chula Vista, CA 91910 | 2019-05-09 |
| 1598232506 | Naria Le Mire | Dietitian, Registered | 288 Broadway #141a, Chula Vista, CA 91910 | 2018-10-28 |
| 1730676727 | Pei Chi Chain | Optometrist | 324 F Street., Chula Vista, CA 91910 | 2018-04-16 |
| 1104332741 | Teodoro David Pena | Dentist | 510 Broadway Ste 4-5, Chula Vista, CA 91910 | 2017-12-19 |
| 1538684865 | Camille Cooke | Counselor | 430 F. Street, Chula Vista, CA 91910 | 2017-08-08 |
| 1184146094 | Alexandra Lynn Scovill | Optometrist | Castillejos Eye Institute Medical Group, 342 F Street, Chula Vista, CA 91910 | 2017-07-12 |
| 1396270583 | Tam Trieu | Pharmacist | 555 Broaway Suite 1054, Chula Vista, CA 91910 | 2017-04-25 |
| 1548792815 | Sabrina Owens | Family Medicine | 499 H Street Cv112, Chula Vista, CA 91910 | 2017-03-28 |
| Find all providers in zip 91910 | ||||
| Taxonomy Code | 207Q00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Family Medicine |
| Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity. |
| Notes: Source: American Board of Family Medicine [1/1/2007: changed title; 7/1/2007: added definition, added source; 7/1/2017: modified definition] - Note: The American Osteopathic Board of Family Physicians certification includes extensive use of Osteopathic Manipulative Treatment (OMT), which integrates the biological, clinical, and behavioral sciences. - Additional Resources: American Board of Family Medicine, www.theabfm.org. American Osteopathic Board of Family Physicians, www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Family Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Family Physicians or the American Board of Family Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1588197826 | Miguel Alvarez-estrada | Family Medicine | 480 Fourth Ave Ste 403, Chula Vista, CA 91910-4413 | 2017-04-04 |
| 1548792815 | Sabrina Owens | Family Medicine | 499 H Street Cv112, Chula Vista, CA 91910 | 2017-03-28 |
| 1285088013 | Yelennia Palacios | Family Medicine | 480 4th Ave Ste 403, Chula Vista, CA 91910-4413 | 2016-04-18 |
| 1437554979 | Martin Kabongo, M.d., Apc | Family Medicine | 1040 Tierra Del Rey Ste 107, Chula Vista, CA 91910-7865 | 2014-10-27 |
| 1396167813 | Mohammed K Elsayed A Proffesional Corporation | Family Medicine | 330 Oxford St Ste 106, Chula Vista, CA 91911-3118 | 2014-01-17 |
| 1760702237 | Jean Rizkallah, Md, Inc | Family Medicine | 450 Fourth Ave., Ste 408, Chula Vista, CA 91910-4430 | 2010-06-08 |
| 1174841936 | Jean Rizkallah, Md | Family Medicine | 450 Fouth Ave, Ste 407, Chula Vista, CA 91910-0000 | 2010-05-04 |
| 1033341409 | Andrew J Pasetti | Family Medicine | 644 Naples Street, Toc Chula Vista, Chula Vista, CA 91911 | 2009-08-18 |
| 1831328616 | Marina Udowenko | Family Medicine | 450 Fourth Ave Ste 408, Chula Vista, CA 91910-4430 | 2009-07-14 |
| 1982840518 | Rebecca Smith, Md, Medical Corporation | Family Medicine | 272 Salinas Dr Unit 165, Chula Vista, CA 91914-0444 | 2009-01-03 |
| Find all providers in CHULA VISTA | ||||
| City | CHULA VISTA |
| Zip Code | 91910 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.