Basic Information
| Provider Information | |||||||||
| NPI: | 1083640213 | ||||||||
| EntityType: | 1 | ||||||||
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| LastName: | WAHIDULLAH | ||||||||
| FirstName: | WAHIDULLAH | ||||||||
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| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1548 HILLSBOROUGH ST | ||||||||
| Address2: | |||||||||
| City: | CHULA VISTA | ||||||||
| State: | CA | ||||||||
| PostalCode: | 919132909 | ||||||||
| CountryCode: | US | ||||||||
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| Practice Location | |||||||||
| Address1: | ST JOSEPH HOSPITAL - EUREKA | ||||||||
| Address2: | 2700 DOLBEER ST | ||||||||
| City: | EUREKA | ||||||||
| State: | CA | ||||||||
| PostalCode: | 955014799 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7074458121 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 06/22/2006 | ||||||||
| LastUpdateDate: | 07/08/2007 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207P00000X | A86761 | CA | Y | Allopathic & Osteopathic Physicians | Emergency Medicine |
No ID Information.