Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Dr. Ilavenil Wilson, MD

Individual provider Surgery Physician · NPI 1932510963

Dr. Ilavenil Wilson, MD is a Family Practice in Loma Linda, California. Qualified in 1991, 35 years ago. Practices with Southern California Permanente Medical Group, an 11,242-clinician group and accepts Medicare assignment. Licensed in California.

Years since qualifying
35
Licensed in
CA
In the registry since
2014
Specialties on file
3
What do these letters mean?
MD — Doctor of Medicine
A physician who completed allopathic medical school.

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Practice location Address checks out

25805 Barton Rd Ste 107
Loma Linda, CA 92354-3890
Phone: (909) 709-1975
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Obstetrics & Gynecology Physician (primary) Taxonomy 207V00000X · Licence A143922 (CA)
Surgery Physician Taxonomy 208600000X · Licence A143922 (CA)
General Practice Physician Taxonomy 208D00000X · Licence A143922 (CA)

Record details

NPI number1932510963
Entity typeIndividual (Type 1)
GenderFemale
Credentials MD
Sole proprietorNo
NPI enumeratedMay 13, 2014
Last updated in NPPESDecember 6, 2021

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyFAMILY PRACTICE
Medical schoolOTHER
Graduated 1991 (35 years in practice)
Group practice Southern California Permanente Medical Group — 11242 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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