Wanetick, Sidney Evan

Wanetick, Sidney Evan is an individual health care provider with primary practice located at 19845 Lake Chabot Rd Ste 302, Castro Valley CA 94546-4055. He recently has only one registered license in Allopathic & Osteopathic Physicians / Gynecology, which is considered as his primary health care specialty. Wanetick, Sidney Evan can be contacted via phone (510) 886-3400.

Contact Information

Primary practice address
19845 Lake Chabot Rd Ste 302 Castro Valley CA 94546-4055
Phone: (510) 886-3400
Fax: (510) 886-0861
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Gynecology 207VG0400X G46693 California

Profile Details

NPI number 1508869868
LBN Legal business name Wanetick, Sidney Evan
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date May 31st, 2005
Last updated Jul 8th, 2007 - about 19 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 1508869868 NPPES
California Other G46693 STATE MEDICAL LICENSE

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