Provider Demographics
NPI:1518267616
Name:ARSALA, WAIS NEZAMI (MD)
Entity Type:Individual
Prefix:DR
First Name:WAIS
Middle Name:NEZAMI
Last Name:ARSALA
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:9961 SIERRA AVE
Mailing Address - Street 2:
Mailing Address - City:FONTANA
Mailing Address - State:CA
Mailing Address - Zip Code:92335-6720
Mailing Address - Country:US
Mailing Address - Phone:909-427-5083
Mailing Address - Fax:909-427-5022
Practice Address - Street 1:9961 SIERRA AVE
Practice Address - Street 2:
Practice Address - City:FONTANA
Practice Address - State:CA
Practice Address - Zip Code:92335-6720
Practice Address - Country:US
Practice Address - Phone:909-427-5083
Practice Address - Fax:909-427-5022
Is Sole Proprietor?:No
Enumeration Date:2010-10-24
Last Update Date:2021-12-15
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
CAA114365207QS0010X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207QS0010XAllopathic & Osteopathic PhysiciansFamily MedicineSports Medicine