Individual
DR. HAKAN ERIK WAHLSTROM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
4500 BROCKTON AVE., SUITE 306, RIVERSIDE, CA 92501-4027
(951) 275-9000
(951) 275-5262
Mailing address
4500 BROCKTON AVE., SUITE 306, RIVERSIDE, CA 92501-4027
(951) 275-9000
(951) 275-5262
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
A37140
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00A371400
—
CA
Enumeration date
07/16/2006
Last updated
01/28/2019
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