Dr. Keith Jay Wahl
Facial Plastic Surgeon
8735 Nottingham Pl
La Jolla
, California 92037-2129
Dr. Keith Jay Wahl
Facial Plastic Surgeon
8735 Nottingham Pl
La Jolla
, California 92037-2129
(858) 455-0655
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About
Features
Specialties
- Facial Plastic Surgeon
Languages spoken
- English
Location
First Address
- Dr. Keith Jay Wahl
- 8735 Nottingham Pl
- La Jolla, CA
- Zip : 92037-2129
- Fax : (858) 455-0655
- Phone : (858) 518-2190
Second Address
- Dr. Keith Jay Wahl
- 8735 Nottingham Pl
- La Jolla, CA
- Zip : 92037-2129
- Fax : (858) 455-0655
- Phone : (858) 518-2190
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Scope of Practice
| Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
|---|---|---|---|---|
| Y | 207YS0123X | Facial Plastic Surgeon | A24790 | CA |
National Provider Identifier
| NPI | 1154743987 |
|---|---|
| Provider Name | Dr. Keith Jay Wahl |
| First Address | La Jolla, CA 92037-2129 |
| Second Address | La Jolla, CA 92037-2129 |
| Gender | M |
| NPI Entity type | Individual |
| Is Sole Proprietor | Yes |
| Is Organization Subpart | N/A |
| Enumeration Date | 14/01/2014 |
| Last Update Date | 30/04/2019 |
NPI Footnotes
What is the National Provider Identifier (NPI)
Provider Location Address
Provider Mailing Address
Entity Type Code
1= Person: individual human being who furnishes health care;
2= Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)
What is a Subpart?
Provider Other Organization Name
1 = former name;
2 = professional name;
3 = doinq business as (d/b/ a) name;
4 = former legal business name;
5 = other.