LIBBY WILSON MD INC (NPI# 1548659170) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1548659170 |
| Entity Type | Organization |
| Organization Name | LIBBY WILSON MD INC |
| Practice Address |
403 W Adams Blvd Los Angeles CA 90007-2664 |
| Practice Telephone | 2137421433 |
| Practice Fax Number | 2137421496 |
| Mailing Telephone | 2137421433 |
| Mailing Fax Number | 2137421496 |
| Enumeration Date | 2015-01-20 |
| Last Update Date | 2015-01-20 |
| Authorized Official Name | LIBBY F WILSON (PRESIDENT) |
| Authorized Official Telephone | 2137421433 |
| Authorized Official Credential | M.D. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2086S0122X |
Surgery Specialization: Plastic and Reconstructive Surgery |
G18778 | CA | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| CA | 00G187780 | 05 |
| Street Address |
403 W ADAMS BLVD |
| City | LOS ANGELES |
| State | CA |
| Zip Code | 90007-2664 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1831171602 | Orthopaedic Rehabilitation Specialists Inc | Occupational Therapist | 403 W Adams Blvd, Los Angeles, CA 90007-2664 | 2005-11-17 |
| 1851900856 | Enda Kelly | Student in an Organized Health Care Education/Training Program | 403 W Adams Blvd, Los Angeles, CA 90007-2664 | 2020-07-26 |
| 1902454051 | Alexandra Nicole Santellano-bartsch | Orthopaedic Surgery | 403 W Adams Blvd, Los Angeles, CA 90007-2664 | 2019-09-02 |
| 1063069730 | Mirna Aracely Guzman | Physical Therapy Assistant | 403 W Adams Blvd, Los Angeles, CA 90007-2664 | 2019-08-19 |
| 1578125035 | Help Them Smile | Voluntary or Charitable | 403 W Adams Blvd, Los Angeles, CA 90007-2664 | 2019-07-05 |
| 1376019919 | Summer Bloom Runestad | Specialist/Technologist | 403 W Adams Blvd, Los Angeles, CA 90007-2664 | 2018-10-22 |
| 1770090227 | Kathryn Williams | Nurse Practitioner | 403 W Adams Blvd, Los Angeles, CA 90007-2664 | 2018-01-05 |
| 1326581208 | Jessica Mofidi | Pediatrics | 403 W Adams Blvd, Los Angeles, CA 90007-2664 | 2016-11-28 |
| 1326402884 | Orthopaedic Institute for Children Ambulatory Surgery Center, LLC | Clinic/Center | 403 W Adams Blvd, Los Angeles, CA 90007-2664 | 2016-04-11 |
| 1396110425 | Christine Caron | Physical Therapist | 403 W Adams Blvd, Los Angeles, CA 90007-2664 | 2015-12-01 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1093278632 | St. John's Well Child and Family Center, Inc. | Clinic/Center | 1060 West Exposition Blvd., Los Angeles, CA 90007 | 2019-04-10 |
| 1639690803 | Michelle Pittman | Registered Nurse | 2829 South Grand Ave., H. Claude Hudson Chc, Los Angeles, CA 90007 | 2017-06-28 |
| 1568983773 | Debbie Sharon Gillett | Registered Nurse | 2829 South Grand Avenue, H. Claude Hudson Health Center, Los Angeles, CA 90007 | 2017-06-28 |
| 1043749435 | Tamika Brown | Driver | 2947 Van Buren Place, Los Angeles, CA 90007 | 2017-06-08 |
| 1356891857 | Eli Gendler | General Practice | 2501 South Hill St., Los Angeles, CA 90007 | 2016-10-07 |
| 1770037715 | Jennifer R Knutson | Nurse Practitioner | 2409 S. Vermont Ave., Los Angeles, CA 90007 | 2016-08-08 |
| 1386006088 | Matthew Welzenbach | Internal Medicine | St. John's Well Child, 1910 Magnolia Ave #101, Los Angeles, CA 90007 | 2016-03-22 |
| 1316315765 | Gary L Nollins | Counselor | 145 W 22ns Street, Los Angeles, CA 90007 | 2015-09-02 |
| 1861882698 | Tarlan, P. Akhavan Dds A Prof Corp | Dentist | 2407 South Vermont Ave, Los Angeles, CA 90007 | 2015-02-02 |
| 1316341258 | Jessica Huang | Student in an Organized Health Care Education/Training Program | 854 West Adams Blvd, Los Angeles, CA 90007 | 2014-10-21 |
| Find all providers in zip 90007 | ||||
| Taxonomy Code | 2086S0122X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Surgery |
| Specialization | Plastic and Reconstructive Surgery |
| A surgeon who specializes in plastic and reconstructive surgery. |
| Notes: Source: National Uniform Claim Committee, 2009 [1/1/2010: definition added, source added] Additional Resources: A General Certificate is issued by the American Osteopathic Board of Surgery. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1447560289 | Tadeusz Wellisz | Surgery | 536 South Rimpau Blvd, Los Angeles, CA 90020 | 2010-10-14 |
| 1801971478 | Kyoung Chol Kim | Surgery | 2970 W Olympic Blvd, Suite 204 & 205, Los Angeles, CA 90006-2518 | 2006-10-25 |
| 1770006538 | Debra Ann Wallace | Surgery | 1100 N State Street, Clinic Tower A6a231a, Los Angeles, CA 90033 | 2017-07-24 |
| 1003369380 | Integrative Medical Group, Inc | Surgery | 2200 W 3rd St, Suite 120 A, Los Angeles, CA 90057-1932 | 2016-08-03 |
| 1841659042 | Ryan Spivak Integrative Plastic Surgery Inc | Surgery | 2200 W 3rd St, Suite 120a, Los Angeles, CA 90057-1932 | 2016-02-16 |
| 1811330566 | Ginger C Slack | Surgery | 200 Ucla Medical Plz Ste 460, Los Angeles, CA 90095-5224 | 2013-04-12 |
| 1265705925 | Gary Motykie, M.d. A Medical Corporation | Surgery | 9201 W Sunset Blvd, Suite Gf-1, Los Angeles, CA 90069-3701 | 2012-02-10 |
| 1851607642 | Mark L Labowe M D A Prof Corp | Surgery | 12301 Wilshire Blvd, Suite 325, Los Angeles, CA 90025-1007 | 2010-08-31 |
| 1699003731 | Jeffrey D Hoefflin Md Inc | Surgery | 9201 W Sunset Blvd, Ste.#805, Los Angeles, CA 90069-3701 | 2009-12-01 |
| 1255579272 | Anita Patel, M.d., Inc. | Surgery | 1245 Wilshire Blvd, Suite 601, Los Angeles, CA 90017-4810 | 2009-01-29 |
| Find all providers in LOS ANGELES | ||||
| City | LOS ANGELES |
| Zip Code | 90007 |
Please comment or provide details below to improve the information on LIBBY WILSON MD INC.
| 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.