DR. KEITH JAY WAHL (NPI# 1154743987) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1154743987 |
| Entity Type | Individual |
| Full Name | DR. KEITH JAY WAHL |
| Credential | MD |
| Practice Address |
8735 Nottingham Pl La Jolla CA 92037-2129 |
| Practice Telephone | 8585182190 |
| Practice Fax Number | 8584550655 |
| Mailing Telephone | 8585182190 |
| Mailing Fax Number | 8584550655 |
| Enumeration Date | 2014-01-14 |
| Last Update Date | 2019-04-30 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207YS0123X |
Otolaryngology Specialization: Facial Plastic Surgery |
A24790 | CA | Allopathic & Osteopathic Physicians |
| Street Address |
8735 NOTTINGHAM PL |
| City | LA JOLLA |
| State | CA |
| Zip Code | 92037-2129 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1982221768 | Equip Health Medical, PC | Clinic/Center | 2674 Costebelle Drive, Unit A, La Jolla, CA 92037 | 2020-06-29 |
| 1134745474 | Brenda Kay Wiederhold | Psychologist | Virtual Reality Medical Center, 9834 Genesee Avenue, Suite 427, La Jolla, CA 92037 | 2020-06-23 |
| 1316581598 | Kathleen M Blechertas | Physical Therapist | 9888 Genesee, Lj19, La Jolla, CA 92037 | 2019-10-31 |
| 1316592876 | Kevin Yanyan Li | Student in an Organized Health Care Education/Training Program | 9300 Campus Point Drive, Mc7400, La Jolla, CA 92037 | 2019-08-01 |
| 1407400542 | Juan J Salmeron | Dentist | Callejin Internacional 351 L2, Los Algodones, BAJA CALIFORNIA 92037 | 2019-07-26 |
| 1609428598 | Nicole Whitney Mark | Physician Assistant | 8103 Caminito Sonoma, La Jolla, CA 92037 | 2019-07-11 |
| 1700357936 | Cecelia Rose Greene/pendzich | Mastectomy Fitter | 7760 Fay Ave, Suite M., La Jolla, CA 92037 | 2018-12-16 |
| 1740765890 | Jeenal Ankit Gordhandas | Student in an Organized Health Care Education/Training Program | East Campus Office Building, Medical Center Dr, La Jolla, CA 92037 | 2018-09-25 |
| 1306325220 | Lisa Beth Perlov Marks | Marriage & Family Therapist | 7734 Hershel Avenue, Suite O, La Jolla, CA 92037 | 2018-08-10 |
| 1023596731 | Uc San Diego, Pathology Dept | Pathology | East Campus Office Building, Medical Center Dr, San Diego, CA 92037 | 2018-08-03 |
| Find all providers in zip 92037 | ||||
| Taxonomy Code | 207YS0123X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Otolaryngology |
| Specialization | Facial Plastic Surgery |
| An otolaryngologist who specializes in facial plastic surgery. |
| Notes: Source: National Uniform Claim Committee, 2009 [1/1/2010: definition added, source added] Additional Resources: A General Certificate was, but is no longer issued by the American Osteopathic Board of Ophthalmology and Otolaryngology. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1730130287 | Roy Aaron David | Otolaryngology | 3252 Holiday Court, Suite: 206, La Jolla, CA 92037 | 2006-05-12 |
| 1588952188 | Kolstad Plastic Surgery | Otolaryngology | 9850 Genesee Ave, Suite 460, La Jolla, CA 92037-1224 | 2011-07-16 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1114550498 | Hootan Zandifar Md Inc | Otolaryngology | 8920 Wilshire Blvd Ste 604, Beverly Hills, CA 90211-2006 | 2020-02-14 |
| 1548751183 | Farhad Ardesh Md Inc | Otolaryngology | 11620 Wilshire Blvd Ste 280, Los Angeles, CA 90025-1263 | 2018-05-18 |
| 1174943377 | Sunny Park Md, Inc | Otolaryngology | 901 Dover Dr Ste 126, Newport Beach, CA 92660-5546 | 2014-04-26 |
| 1295179570 | Ari Joseph Hyman | Otolaryngology | 16311 Ventura Blvd Ste 600, Encino, CA 91436-2134 | 2013-04-17 |
| 1710229893 | Zachary Calnan Fridirici | Otolaryngology | 2233 Post St Fl 3, San Francisco, CA 94115 | 2013-03-26 |
| 1376883975 | Su Mai | Otolaryngology | 13071 Brookhurst St Ste 150, Garden Grove, CA 92843-1024 | 2013-02-20 |
| 1710244892 | Meaghan Noud | Otolaryngology | 421 Post St Fl 14, San Francisco, CA 94102 | 2012-04-13 |
| 1508164500 | Dr. Sasha Maher D.o. | Otolaryngology | 10861 Cherry St Ste 106, Los Alamitos, CA 90720-5403 | 2011-03-01 |
| 1871804187 | Edwin E Breitenbach | Otolaryngology | 2601 Augusta, Tustin, CA 92782-1201 | 2010-07-01 |
| 1467780270 | Robert O Ruder M D A Professional Corporation | Otolaryngology | 8816 Burton Way Fl 1, Beverly Hills, CA 90211-1715 | 2009-12-07 |
| Find all providers with the same taxonomy | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.