Fare, Wisal
Fare, Wisal is an individual health care provider with primary practice located at 13851 E 14Th St Ste 305, San Leandro CA 94578-2631. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Adult Health, which is considered as her primary health care specialty. Fare, Wisal can be contacted via phone (510) 351-1193.Contact Information
Primary practice address
13851 E 14Th St Ste 305
San Leandro CA 94578-2631
Phone: (510) 351-1193
Fax: (510) 351-6456
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Physician Assistants & Advanced Practice Nursing Providers / Adult Health | 364SA2200X | PA13725 | California |
Profile Details
| NPI number | 1578525598 |
|---|---|
| LBN Legal business name | Fare, Wisal |
| Credentials | Physician's Assistant Certified (PA-C) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Apr 5th, 2006 |
| Last updated | Sep 23rd, 2014 - about 12 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1578525598 | NPPES |
| California | Other | 110006522 | PTAN |
| California | Other | ZZZ15328Z | PTAN |
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