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Contact Information

MARK R WILSON, Q.M.E., O.M.D., LAC
1101 S WINCHESTER BLVD
STE L-239
SAN JOSE, CA95128-3901
 Phone: 408-984-2424
 Fax: 409-984-2425
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Acupuncturist

171100000X
Indicates primary specialty

NPI Profile & details for MARK R WILSON · (Male)

NPI # 1013076405
Status Active
Credentials Q.M.E., O.M.D., LAC
Entity Individual
Enumeration date 12/08/2006
Last updated 01/13/2016 - About 4 years ago
Sole proprietor 1 Yes
Identifiers
  • CA License # 005109
Hospital affiliation(s) Not Available
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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