Provider Demographics
NPI:1306954300
Name:ATIYA, WASEF Y (MD)
Entity type:Individual
Prefix:DR
First Name:WASEF
Middle Name:Y
Last Name:ATIYA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:1850 W. FLORIDA AVENUE
Mailing Address - Street 2:
Mailing Address - City:HEMET
Mailing Address - State:CA
Mailing Address - Zip Code:92545-4615
Mailing Address - Country:US
Mailing Address - Phone:951-438-2200
Mailing Address - Fax:909-605-8160
Practice Address - Street 1:1850 W. FLORIDA AVENUE
Practice Address - Street 2:
Practice Address - City:HEMET
Practice Address - State:CA
Practice Address - Zip Code:92545-4615
Practice Address - Country:US
Practice Address - Phone:951-438-2200
Practice Address - Fax:909-605-8160
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-29
Last Update Date:2021-05-17
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
CAA23839207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAA26947Medicare UPIN