Provider Demographics
NPI:1508064387
Name:WILKINSON, KATIE ERIN (MD)
Entity type:Individual
Prefix:
First Name:KATIE
Middle Name:ERIN
Last Name:WILKINSON
Suffix:
Gender:
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2901 W COAST HWY STE 200
Mailing Address - Street 2:
Mailing Address - City:NEWPORT BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:92663-4045
Mailing Address - Country:US
Mailing Address - Phone:949-891-1297
Mailing Address - Fax:
Practice Address - Street 1:2901 W COAST HWY STE 200
Practice Address - Street 2:
Practice Address - City:NEWPORT BEACH
Practice Address - State:CA
Practice Address - Zip Code:92663-4045
Practice Address - Country:US
Practice Address - Phone:949-981-1297
Practice Address - Fax:949-258-4354
Is Sole Proprietor?:No
Enumeration Date:2007-07-03
Last Update Date:2025-03-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA100684207ZP0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207ZP0102XAllopathic & Osteopathic PhysiciansPathologyAnatomic Pathology & Clinical Pathology