Provider Demographics
NPI:1912494717
Name:WILSON, CHRISTOPHER EVAN (DO)
Entity Type:Individual
Prefix:
First Name:CHRISTOPHER
Middle Name:EVAN
Last Name:WILSON
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9802 STOCKDALE HWY STE 105
Mailing Address - Street 2:
Mailing Address - City:BAKERSFIELD
Mailing Address - State:CA
Mailing Address - Zip Code:93311-3653
Mailing Address - Country:US
Mailing Address - Phone:661-665-7880
Mailing Address - Fax:661-735-3952
Practice Address - Street 1:9802 STOCKDALE HWY STE 105
Practice Address - Street 2:
Practice Address - City:BAKERSFIELD
Practice Address - State:CA
Practice Address - Zip Code:93311-3653
Practice Address - Country:US
Practice Address - Phone:661-665-7880
Practice Address - Fax:661-735-3952
Is Sole Proprietor?:No
Enumeration Date:2018-04-17
Last Update Date:2023-08-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXBP10063871207L00000X
CA201A19647207L00000X
CA20A19647207LP2900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207LP2900XAllopathic & Osteopathic PhysiciansAnesthesiologyPain Medicine
No207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology