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Search › California › 208100000X

Ethan Wilson

NPI 1285334276 · on the registry since 2023

Practice

Address
11301 Wilshire Blvd
Los Angeles, CA 90073
Phone
(310) 478-3711
Organisation at this address
Va Glahs
Veterans Affairs
Va Medical Center
The Salvation Army
New Directions, Inc.
Inferred from a shared address, not stated in the registry.
Clinicians at this address
1,305

Additional practice sites

  • 3249 Oak Park Ave, Berwyn, IL

Registry record

Primary taxonomy
208100000X
208100000X
Also registered as
207R00000X
390200000X
390200000X
Licence states on file
IL, CA
From the registry's licence fields, which are often incomplete.
Sex
Male
Record last updated
2025-06-06

Source: CMS National Plan and Provider Enumeration System. Registration is not the same as practising, and the registry records no retirement — some people listed here no longer practise. More in California