ETHAN WILSON

LOS ANGELES, CA
NPI1285334276
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy208100000X Physical Medicine & Rehabilitation
(Licence: CA  125.083306)
Additional Taxonomies207R00000X Internal Medicine
(Licence: IL  125.083306)
390200000X Student in an Organized Health Care Education/Training Program
390200000X Student in an Organized Health Care Education/Training Program
(Licence: IL  125.083306)
Enumeration Date2023-03-08
Last Update Date2025-06-06
Business Address
ETHAN WILSON
11301 WILSHIRE BLVD
LOS ANGELES, CA 90073-1003
Phone number: 310-478-3711
Mailing Address
ETHAN WILSON
11301 WILSHIRE BLVD
LOS ANGELES, CA 90073-1003
Phone number: 310-478-3711