Individual
MUSTAPHA WALLY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
RRT
Contact information
Practice address
6775 GOLDEN GATE DR APT 152, DUBLIN, CA 94568-4369
(925) 487-5539
Mailing address
6775 GOLDEN GATE DR APT 152, DUBLIN, CA 94568-4369
(925) 487-5539
Taxonomy
Speciality
Code
Description
License number
State
2278C0205X
Critical Care Certified Respiratory Therapist
Primary
27280
CA
Other
Enumeration date
01/29/2019
Last updated
01/29/2019
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