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DR. FRED W WAKIL M.D.

Emergency Medical Services >> Emergency Medicine >> Allopathic & Osteopathic Physicians

Registrant NPI Number: 1710931464

Individual Registrant:
DR. FRED W WAKIL M.D.
Gender: M
Sole Proprietor

Location and contact information for practice:
500 B STREET SUITE B  SCOTIA, CA 95565 US
Tel: 707-764-5617  Fax: 707-764-5618

Contact information for business:
PO BOX 4  MAD RIVER, CA 95552-0004 US
Tel: 707-496-5688  Fax: --

Registration Information:
NPI: 1710931464
Entity Type: Individual

Specialty information:

PrimaryCodeCategory/DescriptionStateLicense Number
N207PE0004XAllopathic & Osteopathic Physicians
Emergency Medicine
Emergency Medical Services
CAG49172
Y207Q00000XAllopathic & Osteopathic Physicians
Family Medicine
CAG49172

Legacy codes, insurance codes and state license numbers:

IssuerNumberStateType
CA370807CA05




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