IndividualActive
Keith Wahl, MD
NPI 1154743987 · Facial Plastic Surgery Physician · La Jolla, CA
Provider details
- NPI number
- 1154743987
- Entity type
- Individual
- Primary specialty
- Facial Plastic Surgery PhysicianAllopathic & Osteopathic Physicians
- Credential
- MD
- Sex
- Male
- Sole proprietor
- Yes
- License
- A24790 (CA)
Practice location
8735 Nottingham Pl
La Jolla, CA 92037-2129
Phone: (858) 518-2190
Fax: (858) 455-0655
Mailing address
8735 Nottingham Pl
La Jolla, CA 92037-2129
Registry dates
- Enumerated
- 2014-01-14
- Last updated
- 2019-04-30
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.