Provider Demographics
NPI:1467781260
Name:WAHBA, ANGEY
Entity Type:Individual
Prefix:
First Name:ANGEY
Middle Name:
Last Name:WAHBA
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:641 N. ESCONDIDO BLVD
Mailing Address - Street 2:
Mailing Address - City:ESCONDIDO
Mailing Address - State:CA
Mailing Address - Zip Code:92025-1701
Mailing Address - Country:US
Mailing Address - Phone:858-564-9069
Mailing Address - Fax:858-345-3911
Practice Address - Street 1:9528 MIRAMAR ROAD #46
Practice Address - Street 2:
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92126-4533
Practice Address - Country:US
Practice Address - Phone:858-564-9069
Practice Address - Fax:858-345-3911
Is Sole Proprietor?:Yes
Enumeration Date:2009-12-08
Last Update Date:2011-10-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)