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General NPI Number Information
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NPI Number | 1083257968
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Entity Type | Organization
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Legal Business Name | WASIM H RAJA MD
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Dates
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Enumeration Date | 10/23/2019
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Last Update Date | 10/06/2022
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Provider Practice Location Address
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Address Line | 11100 WARNER AVE STE 110
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City | FOUNTAIN VALLEY
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State | CA
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Zip | 92708-7500
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Country | US
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Telephone | 714-486-3477
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Fax | 833-334-0495
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Provider Business Mailing Address
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Address Line | 11100 WARNER AVE STE 110
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City | FOUNTAIN VALLEY
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State | CA
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Zip | 92708-7500
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Country | US
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Telephone | 714-486-3477
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Fax | 833-334-0495
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Authorized Official
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Title or Position | MD
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Name | WASIM H RAJA
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Credential | MD
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Telephone | 916-934-4002
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number |
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License Number State |
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