Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RH0003X | Hematology & Oncology | PA20307 | CA |
NPI | 1053543744 |
---|---|
Provider Name | Peter Nazmi Wahba |
First Address | Long Beach, CA 90813-3271 |
Second Address | Long Beach, CA 90813-3271 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 14/08/2009 |
Last Update Date | 14/08/2009 |