Provider Demographics
NPI:1013368315
Name:WILHELM, ISABEL ELODIA (PA-C)
Entity Type:Individual
Prefix:
First Name:ISABEL
Middle Name:ELODIA
Last Name:WILHELM
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:19524 AVENIDA DEL CAMPO
Mailing Address - Street 2:
Mailing Address - City:WALNUT
Mailing Address - State:CA
Mailing Address - Zip Code:91789-1607
Mailing Address - Country:US
Mailing Address - Phone:909-731-4761
Mailing Address - Fax:
Practice Address - Street 1:19524 AVENIDA DEL CAMPO
Practice Address - Street 2:
Practice Address - City:WALNUT
Practice Address - State:CA
Practice Address - Zip Code:91789-1607
Practice Address - Country:US
Practice Address - Phone:909-731-4761
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-06-28
Last Update Date:2023-07-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA53549363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant