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Contact Information

JAKE WILSON
1600 W AVENUE J
LANCASTER, CA93534
 Phone: 661-949-5000
 Fax:
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Emergency Medicine

207P00000X 93 Physician/Emergency Medicine
 

Student in an Organized Health Care Education/Training Program

390200000X
Indicates primary specialty

NPI Profile & details for JAKE WILSON · (Male)

NPI Number 1700203023
Status Active
Credentials
Entity Individual
Enumeration date 03/25/2014
Last updated 03/21/2023 - About 3 years ago
Sole proprietor 1 Yes
Identifiers
  • CA License # A141468
  • WA License # MD61413870
Hospital affiliation(s)
  • ANTELOPE VALLEY HOSPITAL MED CENTER - (Acute Care)
    1600 W AVE J
    LANCASTER, CA 93534
  • REDWOOD MEMORIAL HOSPITAL - (Critical Access)
    3300 RENNER DRIVE
    FORTUNA, CA 95540
  • SAN CARLOS INDIAN HOSPITAL - (Acute Care)
    223 CIBECUE CIRCLE ROAD
    SAN CARLOS, AZ 85550
  • ST FRANCIS MEDICAL CENTER - (Acute Care)
    2620 WEST FAIDLEY AVE
    GRAND ISLAND, NE 68803
  • ST JOSEPH HOSPITAL - (Acute Care)
    2700 DOLBEER ST
    EUREKA, CA 95501
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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