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Ike Wilder

Rehabilitation Practitioner in Palmdale, CA. Individual provider (NPI-1).

NPI number1386970168
StatusActive
Last updated in NPPESMay 13, 2025

Details

NPI
1386970168
Entity type
Individual (NPI-1)
Name
Mr. Ike Wilder
Sex
Male
Sole proprietor
No
Enumeration date
Oct 28, 2009
Certification date
May 13, 2025
Last updated
May 13, 2025

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
225400000X Rehabilitation Practitioner––Yes
171M00000X Case Manager/Care Coordinator––

Practice location

2260 E Palmdale Blvd Ste 260
Palmdale, CA 93550-4952

Phone 661-575-1800 · Fax 661-793-6882

Mailing address

2260 E Palmdale Blvd Ste 260
Palmdale, CA 93550-4952

Phone 661-575-1800

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