Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2086S0120X | Pediatric Surgery | G34261 | CA |
NPI | 1346317369 |
---|---|
Provider Name | George E. Wilkinson Jr. |
First Address | Los Angeles, CA 90034-1702 |
Second Address | Los Angeles, CA 90034-1702 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 29/11/2006 |
Last Update Date | 29/11/2021 |