Most Relevant Information
Provider Data
| NPI Number: | 1003364191 |
| Provider Name: | TAYLOR SUZANNE WAHL PA-C |
| Entity Type: | Individual |
| Taxonomy Code: | 363A00000X |
| Specialty: | Physician Assistant |
| License Number: |
Most Important Dates
| Enumeration Date: | 09/16/2016 |
| Last Updated: | 08/30/2019 |
Provider Practice Location
1235 OSOS ST # 100
SAN LUIS OBISPO
CA
934013619
Practice Location Phone/Fax
| Phone: | 8055490888 |
| Fax: |
Provider Mailing Location
1235 OSOS ST # 100
SAN LUIS OBISPO
CA
934013619
Provider Mailing Phone/Fax
| Phone: | 8055490888 |
| Fax: |