Healthcare Provider Details

I. General information

NPI: 1457289886
Provider Name (Legal Business Name): BILAL WURIE
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/13/2026
Last Update Date: 05/13/2026
Certification Date: 05/13/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2400 S AVENUE A
YUMA AZ
85364-7127
US

IV. Provider business mailing address

1482 5TH AVE RM C-1
SAN FRANCISCO CA
94122-3807
US

V. Phone/Fax

Practice location:
  • Phone: 928-336-2000
  • Fax:
Mailing address:
  • Phone: 240-802-9091
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: