Provider Demographics
NPI:1891857405
Name:WAKIM, PAUL EMILE (DO)
Entity type:Individual
Prefix:DR
First Name:PAUL
Middle Name:EMILE
Last Name:WAKIM
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
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Mailing Address - Street 1:18800 DELAWARE ST SUITE 1100
Mailing Address - Street 2:
Mailing Address - City:HUNTINGTON BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:92648-5524
Mailing Address - Country:US
Mailing Address - Phone:714-841-5333
Mailing Address - Fax:714-841-5303
Practice Address - Street 1:18800 DELAWARE ST STE 1100
Practice Address - Street 2:
Practice Address - City:HUNTINGTON BEACH
Practice Address - State:CA
Practice Address - Zip Code:92648-6021
Practice Address - Country:US
Practice Address - Phone:714-841-5333
Practice Address - Fax:714-841-5303
Is Sole Proprietor?:No
Enumeration Date:2006-12-14
Last Update Date:2017-10-24
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CA20A4964207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA33-0978401OtherTAX IDENTIFICATION NUMBER