Most Relevant Information
Provider Data
| NPI Number: | 1003809765 |
| Provider Name: | LISHA LYNNE WILSON MD |
| Entity Type: | Individual |
| Taxonomy Code: | 207R00000X |
| Specialty: | Internal Medicine |
| License Number: | G73584 |
Most Important Dates
| Enumeration Date: | 08/29/2005 |
| Last Updated: | 08/09/2016 |
Provider Practice Location
400 29TH ST
STE 501
OAKLAND
CA
946093550
Practice Location Phone/Fax
| Phone: | 5102681800 |
| Fax: | 5102681803 |
Provider Mailing Location
400 29TH ST
STE 501
OAKLAND
CA
946093550
Provider Mailing Phone/Fax
| Phone: | 5102681800 |
| Fax: | 5102681803 |
Suggested EMR
Internist EMR