Michael James Wade D.O.

NPI 1194723668 - Family Medicine - 207Q00000X

NPI Details
NPI 1194723668
Gender Male
Enumeration Date 07/08/2005
Last Updated 07/08/2007
Entity Type Individual
Active Over 11 years ago
Practice Location
791 ORCHARD ST
COACHELLA CA, 92236-1730, US
Phone (760) 398-0128
Fax (760) 398-0317
Business Location
PO BOX 10603
PALM DESERT CA, 92255-0603, US
Phone (714) 404-7041
Fax (760) 406-5697
Toxanomy
Taxonomy Code 207Q00000X
License State California
License Number 20A59820
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According to our database, Dr. Michael James Wade D.O. NPI is 1194723668, taxonomy code is 207Q00000X and license number is 20A59820, license state is located at California. Michael James Wade D.O. physically located at 791 Orchard St, Coachella CA, 92236-1730. NPI Number Michael James Wade D.O. has the Individual type.

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1194723668 NPI number is provided on an as is basis without warranty of any kind. 1194723668 is maintained by the National Plan & Provider Enumeration System. The contents of Michael James Wade D.O. are for informational purposes only.