Wali, Autar Kristen

Wali, Autar Kristen is an sole proprietor health care provider with primary practice located at 155 W Willow St , Pomona CA 91768-1829. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Surgery, Allopathic & Osteopathic Physicians / Colon & Rectal Surgery. Allopathic & Osteopathic Physicians / Colon & Rectal Surgery is his primary health care specialty. Wali, Autar Kristen can be contacted via phone (909) 865-2626.

Contact Information

Primary practice address
155 W Willow St Pomona CA 91768-1829
Phone: (909) 865-2626
Fax: (909) 865-2010
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Surgery 208600000X A32290 California
Allopathic & Osteopathic Physicians / Colon & Rectal Surgery 208C00000X A32290 California

Profile Details

NPI number 1164601449
LBN Legal business name Wali, Autar Kristen
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Nov 2nd, 2007
Last updated Oct 20th, 2016 - about 8 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 1164601449 NPPES
California MEDICAID 00A322900
California MEDICAID GR0081880

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