Individual
DR. KEITH JAY WAHL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
8735 NOTTINGHAM PL, LA JOLLA, CA 92037-2129
(858) 518-2190
(858) 455-0655
Mailing address
8735 NOTTINGHAM PL, LA JOLLA, CA 92037-2129
(858) 518-2190
(858) 455-0655
Taxonomy
Speciality
Code
Description
License number
State
207YS0123X
Facial Plastic Surgery Physician
Primary
A24790
CA
Other
Enumeration date
01/14/2014
Last updated
04/30/2019
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