Basic Information
| Provider Information | |||||||||
| NPI: | 1336436369 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | GEORGE M WAHBA MD INC | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 2323 | ||||||||
| Address2: | |||||||||
| City: | BAKERSFIELD | ||||||||
| State: | CA | ||||||||
| PostalCode: | 933032323 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6613240300 | ||||||||
| FaxNumber: | 6613244095 | ||||||||
| Practice Location | |||||||||
| Address1: | 400 OLD RIVER RD | ||||||||
| Address2: | |||||||||
| City: | BAKERSFIELD | ||||||||
| State: | CA | ||||||||
| PostalCode: | 933119781 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6616636550 | ||||||||
| FaxNumber: | 6616636259 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 06/28/2011 | ||||||||
| LastUpdateDate: | 08/26/2011 | ||||||||
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| AuthorizedOfficialLastName: | WAHBA | ||||||||
| AuthorizedOfficialFirstName: | GEORGE | ||||||||
| AuthorizedOfficialMiddleName: | M | ||||||||
| AuthorizedOfficialTitleorPosition: | PRESIDENT | ||||||||
| AuthorizedOfficialTelephone: | 6613240300 | ||||||||
| IsSoleProprietor: | |||||||||
| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialNamePrefix: | DR. | ||||||||
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| AuthorizedOfficialCredential: | M.D. | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207XS0117X | A97606 | CA | N | 193200000X MULTI-SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Orthopaedic Surgery | Orthopaedic Surgery of the Spine | 207X00000X | A97606 | CA | Y | 193200000X MULTI-SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Orthopaedic Surgery |
No ID Information.