Wan, San

Wan, San is an individual health care provider with primary practice located at 340 Wood Rd , Braintree MA 02184-2401. He recently has only one registered license in Allopathic & Osteopathic Physicians / Dermatology, which is considered as his primary health care specialty. Wan, San can be contacted via phone (781) 849-1111.

Contact Information

Primary practice address
340 Wood Rd Braintree MA 02184-2401
Phone: (781) 849-1111
Fax: (781) 794-2280
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Dermatology 207N00000X 46315 Massachusetts

Profile Details

NPI number 1295707123
LBN Legal business name Wan, San
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Feb 4th, 2006
Last updated Jul 8th, 2007 - about 18 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1295707123 NPPES
Other 01Y000581MA01 ANTHEM
Other 2430963 ANTHEM
Other P00034200 ANTHEM
Other B20406102 ANTHEM
MEDICAID 0156736 ANTHEM
Other 713618 ANTHEM
Other 401197 ANTHEM
Other B36040 ANTHEM
Other 0300380 ANTHEM

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