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Contact Information

MATTHEW THOMAS WILSON MD FACS
436 N. BEDFORD DRIVE
SUITE 103
BEVERLY HILLS, CA90210
 Phone: 310-777-8830
 Fax:
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Neurological Surgery

207T00000X 02 Physician/General Surgery
Indicates primary specialty

NPI Profile & details for MATTHEW THOMAS WILSON MD FACS

NPI Number 1013146539
LBN Legal business name MATTHEW THOMAS WILSON MD FACS
Authorized official MATTHEW WILSON - (PRESIDENT)
Entity Organization
Organization subpart 1 No
Enumeration date 07/06/2009
Last updated 02/08/2012 - About 14 years ago
Identifiers
CA License # A53944
CA Medicaid 00A539440
1 Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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