WILSON MEDICAL GROUP, PC (NPI# 1790315141) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1790315141 |
| Entity Type | Organization |
| Organization Name | WILSON MEDICAL GROUP, PC |
| Practice Address |
4305 Torrance Blvd Ste 508 Torrance CA 90503-4493 |
| Mailing Address |
322 Culver Blvd Ste 171 Playa Del Rey CA 90293-7704 |
| Practice Telephone | 4243926060 |
| Practice Fax Number | 4243926062 |
| Mailing Telephone | 4243926060 |
| Mailing Fax Number | 4243926062 |
| Enumeration Date | 2020-01-23 |
| Last Update Date | 2020-01-23 |
| Authorized Official Name | DR. CARA WILSON (PRESIDENT) |
| Authorized Official Telephone | 4243926060 |
| Authorized Official Credential | MD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 207R00000X | Internal Medicine | Allopathic & Osteopathic Physicians | ||
| N | 261QM0850X |
Clinic/Center Specialization: Adult Mental Health |
Ambulatory Health Care Facilities | ||
| Y | 261QM1300X |
Clinic/Center Specialization: Multi-Specialty |
Ambulatory Health Care Facilities |
| Other Name | Type Code |
|---|---|
| South Bay Behavioral Medicine | Doing Business As Name - Organization |
| Street Address |
4305 TORRANCE BLVD STE 508 |
| City | TORRANCE |
| State | CA |
| Zip Code | 90503-4493 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1356751879 | Cara Meghan Wilson | Internal Medicine | 4305 Torrance Blvd Ste 508, Torrance, CA 90503-4493 | 2014-05-06 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1013562180 | Jason Anthony Maglinao | Chiropractor | 21010 Anza Ave., #12, Torrance, CA 90503 | 2019-08-06 |
| 1891288890 | Ehab Samaan Dds Inc | Dentist | 19019 Hawthorne Blvd Ste 100b, Torrance, CA 90503 | 2018-06-13 |
| 1740771435 | Icare California House Call Practice LLC | Nurse Practitioner | 4460 Spencer St, Torrance, CA 90503 | 2018-05-29 |
| 1396258729 | South Bay Home Care, Inc., Dba Always Best Care - South Bay | In Home Supportive Care | 370 S. Crenshaw Blvd., Ste. E106, Torrance, CA 90503 | 2017-11-07 |
| 1770093023 | Home Care Professional Services, Inc. | In Home Supportive Care | 3838 West Carson Street, Suite 208, Torrance, CA 90503 | 2017-10-01 |
| 1003355686 | Mona Nejad | Dentist | 4305 Torrance Blvd Ste 103, Torrance, CA 90503 | 2017-02-16 |
| 1497114722 | Jacqueline Martinez | Technician, Other | 4201 Torrance Blvd Suite 190, Torrance, CA 90503 | 2016-02-15 |
| 1093196255 | Hanmo Gu | Chiropractor | 3510 Torrance Blvd., Ste 106, Torrance, CA 90503 | 2015-06-13 |
| 1164813341 | Aimee Y Miyazawa | Specialist/Technologist | 20501 Earl St. Ste. 3, Torrance, CA 90503 | 2015-02-10 |
| 1396145231 | Nicole Soghomonian | Social Worker | 5010 Merrill St, Torrance, CA 90503 | 2014-08-28 |
| Find all providers in zip 90503 | ||||
| Taxonomy Code | 261QM1300X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Multi-Specialty |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1285293225 | M Hospital Inc | Clinic/Center | 22617 Hawthorne Blvd, Torrance, CA 90505-2510 | 2019-06-12 |
| 1659625796 | Dr. Dan Chavira Md, A Professional Corporation | Clinic/Center | 3661 Torrance Blvd Ste 200, Torrance, CA 90503-4886 | 2012-10-26 |
| 1649458217 | Western Medical Group, Inc. | Clinic/Center | 21081 S Western Ave, Ste 150, Torrance, CA 90501-1707 | 2008-02-06 |
| 1467541615 | Universal Care | Clinic/Center | 1001 W Carson St, Suite E, Torrance, CA 90502-2051 | 2006-10-12 |
| 1952492860 | Association of South Bay Surgeons | Clinic/Center | 23451 Madison St, Suite 340, Torrance, CA 90505-4763 | 2006-09-27 |
| 1528000866 | Meridian Medical Group, P.C. | Clinic/Center | 20300 S Vermont Ave Ste 215, Torrance, CA 90502-1334 | 2006-06-12 |
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| 1982211843 | Crossover Health Medical Group | Clinic/Center | 5379 Hamner Ave Unit 801, Eastvale, CA 91752-1042 | 2020-09-24 |
| 1164039020 | Crossover Health Medical Group | Clinic/Center | 14329 Frederick St Ste 7-9, Moreno Valley, CA 92553-9003 | 2020-09-24 |
| 1104432673 | Aleracare Medical Group of California | Clinic/Center | 17777 Ventura Blvd Ste 220, Encino, CA 91316-3748 | 2020-09-21 |
| 1205447687 | Shawn Richard Oneill | Clinic/Center | 5979 Trotters Ln, Alta Loma, CA 91701-2644 | 2020-08-11 |
| 1134738032 | Healthworks Med Group of California A Medical Corporation | Clinic/Center | 2821 Scott Blvd Ste 2126, Santa Clara, CA 95050-2549 | 2020-07-27 |
| 1437767951 | Miro Health | Clinic/Center | 260 King St Unit 1505, San Francisco, CA 94107-6415 | 2020-07-21 |
| 1598383895 | Alacrity Patient Services, Inc. | Clinic/Center | 1002 N Hudson Ave Apt 1, Los Angeles, CA 90038-2595 | 2020-07-13 |
| 1306464979 | Aleracare Medical Group of California | Clinic/Center | 4849 Van Nuys Blvd Ste 220, Sherman Oaks, CA 91403-2155 | 2020-07-10 |
| Find all providers with the same taxonomy | ||||
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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.