MEDICARE: WAHIDA NADI HAMID FNP

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363L00000X	Nurse Practitioner	95001707	CA

General Provider Information

NPI Number	:	1164812293
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	WAHIDA NADI HAMID FNP

Provider Business Mailing Address
First Line	:	4535 70TH ST
Second Line	:
City	:	LA MESA
State	:	CA
Zip	:	91942-0701
Country	:	US
Telephone Number	:	619-609-9294
Fax Number	:	619-720-2112

Provider Business Practice Location Address
First Line	:	4535 70TH ST
Second Line	:
City	:	LA MESA
State	:	CA
Zip	:	91942-0701
Country	:	US
Telephone Number	:	619-609-9492
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/27/2015
Last Update Date	:	03/30/2023

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