Fare, Wisal

Fare, Wisal is an individual health care provider with primary practice located at 13851 E 14Th St Ste 305, San Leandro CA 94578-2631. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Adult Health, which is considered as her primary health care specialty. Fare, Wisal can be contacted via phone (510) 351-1193.

Contact Information

Primary practice address
13851 E 14Th St Ste 305 San Leandro CA 94578-2631
Phone: (510) 351-1193
Fax: (510) 351-6456
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Adult Health 364SA2200X PA13725 California

Profile Details

NPI number 1578525598
LBN Legal business name Fare, Wisal
Credentials Physician's Assistant Certified (PA-C)
Entity Individual
Sole proprietor 1 No
Enumeration date Apr 5th, 2006
Last updated Sep 23rd, 2014 - about 11 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1578525598 NPPES
California Other 110006522 PTAN
California Other ZZZ15328Z PTAN

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