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General NPI Number Information
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NPI Number | 1093143356
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Entity Type | Organization
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Legal Business Name | WAHIDULLAH MEDICAL CORPORATION
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Dates
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Enumeration Date | 10/24/2013
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Last Update Date | 11/04/2013
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Provider Practice Location Address
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Address Line | 2440 23RD ST
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City | EUREKA
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State | CA
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Zip | 95501-3203
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Country | US
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Telephone | 815-241-5238
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Fax |
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Provider Business Mailing Address
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Address Line | 2440 23RD ST
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City | EUREKA
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State | CA
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Zip | 95501-3203
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Country | US
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Telephone | 815-241-5238
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Fax |
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Authorized Official
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Title or Position | SOLE OWNER & URGENT CARE PHYSICIAN
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Name | DR. WAHIDULLAH WAHIDULLAH
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Credential | MD
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Telephone | 814-241-5238
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QU0200X
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Taxonomy Name | Urgent Care Clinic/Center
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License Number |
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License Number State |
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