Wali, Autar Kristen
Wali, Autar Kristen is an sole proprietor health care provider with primary practice located at 155 W Willow St , Pomona CA 91768-1829. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Surgery, Allopathic & Osteopathic Physicians / Colon & Rectal Surgery. Allopathic & Osteopathic Physicians / Colon & Rectal Surgery is his primary health care specialty. Wali, Autar Kristen can be contacted via phone (909) 865-2626.Contact Information
Primary practice address
155 W Willow St
Pomona CA 91768-1829
Phone: (909) 865-2626
Fax: (909) 865-2010
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Surgery | 208600000X | A32290 | California |
| Allopathic & Osteopathic Physicians / Colon & Rectal Surgery | 208C00000X | A32290 | California |
Profile Details
| NPI number | 1164601449 |
|---|---|
| LBN Legal business name | Wali, Autar Kristen |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Nov 2nd, 2007 |
| Last updated | Oct 20th, 2016 - about 10 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 | 1164601449 | NPPES |
| California | MEDICAID | 00A322900 | |
| California | MEDICAID | GR0081880 |
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