JACK M WILSON (NPI# 1033125299) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1033125299 |
| Entity Type | Individual |
| Full Name | JACK M WILSON |
| Credential | M.D. |
| Practice Address |
6655 Alvarado Rd San Diego CA 92120-5208 |
| Mailing Address |
2100 Powell St Suite 900 Emeryville CA 94608-1826 |
| Practice Telephone | 6192293130 |
| Mailing Telephone | 5103502777 |
| Enumeration Date | 2006-07-31 |
| Last Update Date | 2007-11-16 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207P00000X | Emergency Medicine | G49906 | CA | Allopathic & Osteopathic Physicians |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1114241239 | Jack H Wilson | Counselor | 11730 Highway 9 West, Stigler, OK 74462 | 2010-03-18 |
| 1821122102 | Jack A. Wilson | Dentist | 2200 Interstate 20 W Ste 200, Arlington, TX 76017-1649 | 2007-03-16 |
| 1396806519 | Jack Wilson | Pharmacist | 8823 Avenue L, Brooklyn, NY 11236-4781 | 2006-12-12 |
| 1790756542 | Jack Edward Wilson | Surgery | 3 Walnut St Ste 100, Lemoyne, PA 17043 | 2006-01-30 |
| 1518941517 | Jack Cook Wilson | Family Medicine | 612 E 9th St, Mountain Home, AR 72653-4804 | 2005-12-02 |
| 1356349559 | Jack Kenney Wilson Jr. | Internal Medicine | 637 S Kerr Ave, Wilmington, NC 28403-8423 | 2005-07-12 |
| 1043216807 | Jack Anthony Wilson | Dental Hygienist | 2654 Stacey Way, National City, CA 91950-7760 | 2005-06-24 |
| 1497949929 | Jack L Wilson | Dentist | 1721 S Cleveland Ave, Suite 100, Sioux Falls, SD 57103-5501 | 2007-08-28 |
| 1316002314 | Jack Wilson | Dentist | 12320 N 32nd St, Suite 1, Phoenix, AZ 85032-7154 | 2006-12-27 |
| 1598774465 | Jack W. Wilson | Dentist | 534 Luzerne St, Mount Ida, AR 71957-9449 | 2006-08-07 |
| Street Address |
6655 ALVARADO RD |
| City | SAN DIEGO |
| State | CA |
| Zip Code | 92120-5208 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1306842950 | Fernando Antonio Zamudio | Internal Medicine | 6655 Alvarado Rd, San Diego, CA 92120-5208 | 2005-06-27 |
| 1427657279 | Eiad Sabia Md Inc | Internal Medicine | 6655 Alvarado Rd, San Diego, CA 92120-5208 | 2020-10-22 |
| 1447886239 | Lung and Sleep Medicine Consultants, Inc. | Internal Medicine | 6655 Alvarado Rd, San Diego, CA 92120-5208 | 2020-03-12 |
| 1215572391 | Lisa Say Meng | Registered Nurse | 6655 Alvarado Rd, San Diego, CA 92120-5208 | 2019-11-12 |
| 1760951263 | Alvarado Radiology Group Inc, A Professional Corporation | Radiology | 6655 Alvarado Rd, San Diego, CA 92120-5208 | 2018-11-14 |
| 1437627312 | Alvarado Hospital, LLC | Psychiatric Unit | 6655 Alvarado Rd, San Diego, CA 92120-5208 | 2018-11-08 |
| 1558844019 | Farschad Birdjandi Md Inc | Internal Medicine | 6655 Alvarado Rd, San Diego, CA 92120-5208 | 2018-09-11 |
| 1053766444 | Alexandra Oleske | Anesthesiology | 6655 Alvarado Rd, San Diego, CA 92120-5208 | 2016-05-04 |
| 1154718013 | Stacey White | Emergency Medicine | 6655 Alvarado Rd, San Diego, CA 92120-5208 | 2015-04-17 |
| 1003230079 | Ben Mousavi | General Acute Care Hospital | 6655 Alvarado Rd, San Diego, CA 92120-5208 | 2014-02-12 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1316550510 | Jessica Elizabeth Knight | Student in an Organized Health Care Education/Training Program | 6383 Alvarado Ct, 310, San Diego, CA 92120 | 2020-08-26 |
| 1770195091 | Julia Roccanova | Student in an Organized Health Care Education/Training Program | 6383 Alvarado Court, Suite 310, San Diego, CA 92120 | 2020-08-18 |
| 1225593601 | Truself Training, Inc | Clinic/Center | 5125 Waring Road, San Diego, CA 92120 | 2019-02-09 |
| 1508381799 | Antin Sachs | In Home Supportive Care | 4420 Rainier Avenue, Suite 202, San Diego, CA 92120 | 2017-08-08 |
| 1588186415 | Matthew B Wilbat | Behavioral Analyst | 6851 Alvarado Rd., #17, San Diego, CA 92120 | 2017-07-12 |
| 1548782923 | Mori Khatibzadeh Dds Inc. | Clinic/Center | 6171 Mission Gorge Road, Suite #114, San Diego, CA 92120 | 2017-07-07 |
| 1306379359 | Ken Samith Oerding | Nurse Practitioner | 5422 Reservoir Drive, E7, San Diego Ca, CA 92120 | 2017-04-06 |
| 1396134409 | Debra Michele Stern-ellis | Social Worker | 4647 Zion Avenue Kaiser Permanente, 2nd Floor - Oncology, San Diego, CA 92120 | 2015-01-13 |
| 1821494717 | Shohreh Tourian | Dentist | 7451 Mission Gorge Road, San Diego, CA 92120 | 2014-11-05 |
| 1184049215 | Charles Yin | Counselor | 6153 Fairmount Ave Suite #260, San Diego, CA 92120 | 2014-02-26 |
| Find all providers in zip 92120 | ||||
| Taxonomy Code | 207P00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Emergency Medicine |
| An emergency physician focuses on the immediate decision making and action necessary to prevent death or any further disability both in the pre-hospital setting by directing emergency medical technicians and in the emergency department. The emergency physician provides immediate recognition, evaluation, care, stabilization and disposition of a generally diversified population of adult and pediatric patients in response to acute illness and injury. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source; 7/1/2011: mofified source] - Additional Resources: American Board of Emergency Medicine, 2007. http://www.abem.org/public/; American Osteopathic Board of Emergency Medicine, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Emergency Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Emergency Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1962947317 | Mark Olcott, M.d., Inc. | Emergency Medicine | 3609 Lotus Dr, San Diego, CA 92106-1136 | 2016-12-21 |
| 1578941019 | Trisha Morshed | Emergency Medicine | 200 W Arbor Dr Mc867, San Diego, CA 92103 | 2015-05-18 |
| 1770995789 | Lindsey Ball | Emergency Medicine | 4647 Zion Ave Ste 1116, San Diego, CA 92120-2507 | 2014-05-24 |
| 1679910558 | Jeffrey Steven Kurz | Emergency Medicine | 3545 Reynard Way, San Diego, CA 92103-3808 | 2013-05-31 |
| 1265876981 | Alexis Lenz | Emergency Medicine | Ucsd 200 W Arbor Dr, Mc8676, San Diego, CA 92103 | 2013-04-24 |
| 1376881078 | Diane Kopeika Gottschalk | Emergency Medicine | 10221 Wateridge Cir, San Diego, CA 92121-2702 | 2013-01-30 |
| 1598000507 | Julie Watkins-torry | Emergency Medicine | 200 W Arbor Dr # Mc8819, San Diego, CA 92103-1911 | 2012-12-02 |
| 1417212739 | Rodney Sidransky | Emergency Medicine | 7841 Balboa Ave, Suite 202, San Diego, CA 92111-2311 | 2012-07-12 |
| 1598044117 | Charlotte Anne Sadler | Emergency Medicine | 200 W Arbor Dr # 8925, San Diego, CA 92103-1911 | 2011-08-12 |
| 1003103235 | Sarah Wilkinson | Emergency Medicine | 200 W Arbor Dr # 8819, San Diego, CA 92103-1911 | 2011-07-08 |
| Find all providers in SAN DIEGO | ||||
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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.