Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207V00000X | Obstetrician & Gynecologist | BP10039746 | TX |
Y | 207VX0000X | Obstetrician | A 137772 | CA |
NPI | 1205171030 |
---|---|
Provider Name | Dr. Lorine L Wilcox |
First Address | San Diego, CA 92154-8404 |
Second Address | San Diego, CA 92154-8404 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 05/12/2012 |
Last Update Date | 21/12/2021 |