Provider Demographics
NPI:1831322536
Name:ALFAY, WISAM ZAKI (MD, FACC)
Entity Type:Individual
Prefix:
First Name:WISAM
Middle Name:ZAKI
Last Name:ALFAY
Suffix:
Gender:M
Credentials:MD, FACC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:33578 MARIGOLD LN
Mailing Address - Street 2:
Mailing Address - City:MURRIETA
Mailing Address - State:CA
Mailing Address - Zip Code:92563-2458
Mailing Address - Country:US
Mailing Address - Phone:949-350-7469
Mailing Address - Fax:949-655-7878
Practice Address - Street 1:26960 CHERRY HILLS BLVD STE C
Practice Address - Street 2:
Practice Address - City:SUN CITY
Practice Address - State:CA
Practice Address - Zip Code:92586-2512
Practice Address - Country:US
Practice Address - Phone:951-301-0300
Practice Address - Fax:949-655-7878
Is Sole Proprietor?:Yes
Enumeration Date:2009-08-27
Last Update Date:2023-07-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA161468207RI0011X, 207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular DiseaseGroup - Single Specialty
No207RI0011XAllopathic & Osteopathic PhysiciansInternal MedicineInterventional CardiologyGroup - Single Specialty