Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207RG0100X | Gastroenterologist | A50595 | CA |
NPI | 1043237712 |
---|---|
Provider Name | Adil Wakil |
First Address | Los Altos, CA 94022-1408 |
Second Address | San Francisco, CA 94109-6978 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 17/07/2006 |
Last Update Date | 16/11/2020 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
A50595 | STATE MEDICAL LICENSE (01) | CA |
E83482 | (02) | CA |
P00104519 | RAILROAD MEDICARE (01) | CA |