Provider Demographics
NPI:1184801573
Name:WILKINSON, NORKA IRIARTE (MD)
Entity type:Individual
Prefix:
First Name:NORKA
Middle Name:IRIARTE
Last Name:WILKINSON
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8791 WINSTON RD
Mailing Address - Street 2:
Mailing Address - City:ANAHEIM
Mailing Address - State:CA
Mailing Address - Zip Code:92804-5134
Mailing Address - Country:US
Mailing Address - Phone:248-719-1804
Mailing Address - Fax:
Practice Address - Street 1:2212 E 4TH ST STE 103
Practice Address - Street 2:
Practice Address - City:SANTA ANA
Practice Address - State:CA
Practice Address - Zip Code:92705-3871
Practice Address - Country:US
Practice Address - Phone:714-571-7700
Practice Address - Fax:714-571-7702
Is Sole Proprietor?:Yes
Enumeration Date:2008-01-28
Last Update Date:2021-10-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA107664261QP2300X
MI4301084572208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
No261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care