Organization
GARY L WADE MD
Active
Organization subpart
No
Provider details
NPI number
Authorized official
GARY L WADE MD (OWNER)
(530) 842-7297
Entity
Organization
Contact information
Practice address
444 BRUCE ST, YREKA, CA 96097-3450
(530) 842-7297
(530) 842-9054
Mailing address
PO BOX 1086, YREKA, CA 96097-1086
(530) 842-7297
(530) 842-9054
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
—
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
GR0041660
—
CA
Enumeration date
11/15/2006
Last updated
02/04/2008
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