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Organization
JAY G. WANI, M.D., INC.
Active
Organization
JAY G. WANI, M.D., INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JAY G WANI M.D. (M.D.)
(209) 525-3113
Entity
Organization
Contact information
Practice address
1401 SPANOS CT, SUITE 102, MODESTO, CA 95355-2810
(209) 525-3113
(209) 525-3114
Mailing address
1401 SPANOS CT, SUITE 102, MODESTO, CA 95355-2810
(209) 525-3113
(209) 525-3114
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
A32304
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
8726716
—
CA
Enumeration date
09/11/2007
Last updated
09/11/2007
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