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MATTHEW WILSON DPM NPI 1699138891


NPI Information

NPI: 1699138891
Provider Name: MATTHEW WILSON, DPM
Classification: Podiatrist - 213ES0103X
Entity Type: Individual

Specialization: Foot & Ankle Surgery

Organization: ALVARADO ORTHOPEDIC MEDICAL GROUP INC

PECOS Registration: Yes

Address:
5555 RESERVOIR DR STE 104
SAN DIEGO, CA
ZIP 92120
Phone: (619) 286-9480
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Matthew Wilson, DPM is a foot and ankle surgery podiatrist in San Diego, CA with 8 years of experience. Matthew Wilson, DPM NPI is 1699138891. The provider is registered as an individual entity type and is a multi-specialty group.

The NPPES NPI record indicates the provider is a male.

Education
Medical School: DES MOINES UNIVERSITY OF OSTEOPATHIC MEDICINE AND HEALTH SCIENCES
Graduation Year:2016

The provider's business location address is:

5555 RESERVOIR DR STE 104
SAN DIEGO, CA
ZIP 92120-198
Phone: (619) 286-9480
Fax: (619) 286-4568

The NPI 1699138891 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA).

The enumeration date for this NPI number is 4/4/2016 and was last updated on 8/19/2020.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1213ES0103XPodiatristFoot & Ankle SurgeryE5700CALIFORNIAYes
2213ES0103XPodiatristFoot & Ankle Surgery00000ARIZONANo
3390200000XStudent in an Organized Health Care Education/Training ProgramOHIONo

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/14/2023

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.