MR. TIMOTHY WILSON (NPI# 1912005422) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1912005422 |
| Entity Type | Individual |
| Full Name | MR. TIMOTHY WILSON |
| Credential | MD |
| Practice Address |
2121 Santa Monica Blvd Santa Monica CA 90404-2303 |
| Mailing Address |
1333 S Mayflower Ave 2nd Floor Monrovia CA 91016-4066 |
| Practice Telephone | 3105827137 |
| Practice Fax Number | 3105827140 |
| Mailing Telephone | 6267753514 |
| Mailing Fax Number | 6264083911 |
| Enumeration Date | 2006-09-20 |
| Last Update Date | 2020-08-21 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 208800000X | Urology | G57490 | CA | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| CA | 00G574900 | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1619173549 | Timothy Allen Wilson | Family Medicine | 9712 E 66th Ter, Raytown, MO 64133-5848 | 2007-06-26 |
| 1720186257 | Timothy Wilson | Dentist | 6868 E Becker Ln, Suite 101, Scottsdale, AZ 85254-6708 | 2006-09-20 |
| 1013946615 | Timothy Jon Wilson | Optometrist | 2413 Wards Rd, Lynchburg, VA 24502-2103 | 2006-07-03 |
| 1417984139 | Timothy P Wilson | Family Medicine | 115b S Illinois Ave, Oak Ridge, TN 37830-6202 | 2006-06-27 |
| 1174588362 | Timothy C Wilson | Orthopaedic Surgery | 1760 Nicholasville Rd Ste 101, Lexington, KY 40503-1410 | 2006-04-19 |
| 1942269253 | Timothy M. Wilson | Anesthesiology | 129 N. Washington St., Sumter, SC 29150 | 2006-03-23 |
| 1487613402 | Timothy R Wilson | Family Medicine | 300 71st Street, Suite 620, Miami Beach, FL 33141-3089 | 2006-03-20 |
| 1194370965 | Timothy J Wilson Jr. | Counselor | 6221 Ne Fourth Plain Blvd Apt 130, Vancouver, WA 98661-7210 | 2019-08-07 |
| 1457871006 | Timothy Andrew Wilson | Emergency Medicine | 1 Childrens Pl, Dept Emergency Medicine, Saint Louis, MO 63110-1002 | 2017-06-25 |
| 1407393358 | Timothy Wilson | Case Manager/Care Coordinator | 2624 9th Ave S, Fargo, ND 58103-2350 | 2017-01-30 |
| Street Address |
2121 SANTA MONICA BLVD |
| City | SANTA MONICA |
| State | CA |
| Zip Code | 90404-2303 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1528062023 | Lisa Martine Chaiken | Radiology | 2121 Santa Monica Blvd, Santa Monica, CA 90404-2303 | 2005-06-13 |
| 1003428673 | Geremy Zhang | Registered Nurse | 2121 Santa Monica Blvd, Santa Monica, CA 90404-2303 | 2020-08-17 |
| 1376152082 | Jennifer Scheller | Student in an Organized Health Care Education/Training Program | 2121 Santa Monica Blvd, Santa Monica, CA 90404-2303 | 2020-07-28 |
| 1710518881 | Niceto Lopez, M.d., A.p.c. | Internal Medicine | 2121 Santa Monica Blvd, Santa Monica, CA 90404-2303 | 2020-01-28 |
| 1780223412 | Genevieve Abanilla Veneracion | Nurse Practitioner | 2121 Santa Monica Blvd, Santa Monica, CA 90404-2303 | 2019-12-28 |
| 1013560515 | Breanne Grazer | Nurse Practitioner | 2121 Santa Monica Blvd, Santa Monica, CA 90404-2303 | 2019-07-23 |
| 1104310002 | Michelle Padilla Martinez | Nurse Practitioner | 2121 Santa Monica Blvd, Santa Monica, CA 90404-2303 | 2018-06-15 |
| 1952815714 | Frania Julianne Ciszewski | Nurse Practitioner | 2121 Santa Monica Blvd, Santa Monica, CA 90404-2303 | 2017-11-30 |
| 1609388271 | Tara Jean Kays | Nurse Practitioner | 2121 Santa Monica Blvd, Santa Monica, CA 90404-2303 | 2017-11-03 |
| 1770093734 | Providence Saint Johns Medical Foundation | Family Medicine | 2121 Santa Monica Blvd, Santa Monica, CA 90404-2303 | 2017-10-04 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1306453352 | Jasmine Burton | Physical Therapist | 1714 17th Street, Santa Monica, CA 90404 | 2020-09-24 |
| 1003431685 | Cintia Haydee Ctibor | Behavior Technician | 1869 9th Street, Santa Monica, CA 90404 | 2020-06-10 |
| 1073137261 | Sydney Kristine Valerio | Counselor | 1869 9th St, Santa Monica, CA 90404 | 2020-06-03 |
| 1710507082 | James Gilbert Cunningham | Marriage & Family Therapist | 1708 Olympic Blvd, Santa Monica, CA 90404 | 2020-04-16 |
| 1841763687 | Crystal Monique Mckinley X | Counselor | 1865 9th St, Santa Monica, CA 90404 | 2019-01-04 |
| 1952872749 | Cesar O Munoz | Licensed Vocational Nurse | 1865 9th St., Santa Monica, CA 90404 | 2018-12-06 |
| 1023596574 | Joseph J Pinzone Md Inc | Internal Medicine | 2001 Santa Monica Blvd Ste 1190, Santa Monica, CA 90404 | 2018-08-06 |
| 1548763535 | Alan Rubenstein Dds Inc | Dentist | 1260 15th St., #703, Santa Monica, CA 90404 | 2018-03-15 |
| 1669993382 | Aaron Wilson | Counselor | 1453 16th Street, Santa Monica, CA 90404 | 2017-07-03 |
| 1922472471 | Chianni Lin | Acupuncturist | 2222 Santa Monica Blvd, Ste. 105, Santa Monica, CA 90404 | 2015-11-20 |
| Find all providers in zip 90404 | ||||
| Taxonomy Code | 208800000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Urology |
| A urologist manages benign and malignant medical and surgical disorders of the genitourinary system and the adrenal gland. This specialist has comprehensive knowledge of and skills in endoscopic, percutaneous and open surgery of congenital and acquired conditions of the urinary and reproductive systems and their contiguous structures. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added] Additional Resources: American Board of Urology, 2007. http://www.abu.org/. Board certification for Medical Doctors (MDs) is provided by the American Board of Urology. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1154518629 | Mehran Movassaghi | Urology | 2001 Santa Monica Blvd Ste 460w, Santa Monica, CA 90404-2178 | 2007-09-28 |
| 1336181965 | Karyn S Eilber | Urology | 2020 Santa Monica Blvd., Suite 570, Santa Monica, CA 90404 | 2006-06-11 |
| 1912996851 | Martin K. Gelbard | Urology | 1260 15th St Ste 1200, Santa Monica, CA 90404-1147 | 2005-10-13 |
| 1922487800 | Jeannie Jiwon Su | Urology | 2121 Santa Monica Blvd, Santa Monica, CA 90404-2303 | 2015-05-25 |
| 1740628866 | Stanley Brosman Medical Corporation | Urology | 2021 Santa Monica Blvd, Suite 510, Santa Monica, CA 90404-2219 | 2013-06-11 |
| 1447503826 | Gregory Scott Jack | Urology | 1260 15th St, 1200, Santa Monica, CA 90404-1135 | 2012-10-22 |
| 1619248184 | Stacey C Carter | Urology | 1260 15th St, Suite 1200, Santa Monica, CA 90404-1135 | 2012-01-15 |
| 1770773269 | Dino T. Deconcini Md Inc | Urology | 2021 Santa Monica Blvd, 510 E, Santa Monica, CA 90404-2160 | 2007-07-31 |
| 1881891042 | Jennifer A Linehan | Urology | 2121 Santa Monica Blvd, Santa Monica, CA 90404-2303 | 2007-06-29 |
| 1538371679 | Zachery Chad Baxter | Urology | 1260 15th St Ste 1200, Santa Monica, CA 90404 | 2007-05-03 |
| Find all providers in SANTA MONICA | ||||
| City | SANTA MONICA |
| Zip Code | 90404 |
Please comment or provide details below to improve the information on MR. TIMOTHY WILSON.
| 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.