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

Ethan Wilson

Individual provider Internal Medicine Physician · NPI 1285334276

Ethan Wilson is an Internal Medicine Physician in Los Angeles, California. Works from 2 locations. Licensed in California and Illinois.

Licensed in
CA, IL
In the registry since
2023
Specialties on file
4
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Practice location Address checks out

11301 Wilshire Blvd
Los Angeles, CA 90073-1003
Phone: (310) 478-3711
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (1)

  • 3249 Oak Park Ave, Berwyn, IL 60402-3429 — (708) 783-9100

Specialties & licences

Physical Medicine & Rehabilitation Physician (primary) Taxonomy 208100000X · Licence 125.083306 (CA)
Internal Medicine Physician Taxonomy 207R00000X · Licence 125.083306 (IL)
Student in an Organized Health Care Education/Training Program Taxonomy 390200000X
Student in an Organized Health Care Education/Training Program Taxonomy 390200000X · Licence 125.083306 (IL)

Record details

NPI number1285334276
Entity typeIndividual (Type 1)
GenderMale
Sole proprietorNo
NPI enumeratedMarch 8, 2023
Last updated in NPPESJune 6, 2025
Certification dateJune 6, 2025

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