Individual
ISMAIL WADIWALA
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
210 N FREMONT ST, MANTECA, CA 95336-4725
(209) 823-1121
(209) 823-0393
Mailing address
210 N FREMONT ST, MANTECA, CA 95336-4725
(209) 823-1121
(209) 823-0393
Taxonomy
Speciality
Code
Description
License number
State
207RG0100X
Gastroenterology Physician
Primary
A42925
CA
Other
Enumeration date
03/14/2006
Last updated
07/08/2007
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