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

Rusty J Wilson, PA

Individual provider Surgical Physician Assistant · NPI 1336751395

Rusty J Wilson, PA is a Physician Assistant in LA Jolla, California. Qualified in 2021, 5 years ago. Practices with Scripps Health, a 1,446-clinician group and accepts Medicare assignment. Licensed in California.

Years since qualifying
5
Licensed in
CA
In the registry since
2020
Specialties on file
2
What do these letters mean?
PA — Physician Assistant
A licensed clinician who examines, diagnoses and treats under a physician's supervision.

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Practice location Address checks out

10710 N Torrey Pines Rd
LA Jolla, CA 92037-1035
Phone: (858) 554-8080
Fax: (858) 554-8231
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Physician Assistant (primary) Taxonomy 363A00000X · Licence PA59998 (CA)
Surgical Physician Assistant Taxonomy 363AS0400X · Licence PA59998 (CA)

Record details

NPI number1336751395
Entity typeIndividual (Type 1)
GenderMale
Credentials PA
Sole proprietorYes
NPI enumeratedAugust 20, 2020
Last updated in NPPESSeptember 16, 2021
Certification dateSeptember 16, 2021
Mailing address10790 Rancho Bernardo Rd, San Diego, CA 92127-5705

Medicare enrollment

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

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolOTHER
Graduated 2021 (5 years in practice)
Group practice Scripps Health — 1446 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations7 on file with Medicare

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