DR. SIDNEY EVAN WANETICK MD NPI 1508869868

NPI Information

NPI: 1508869868
Provider Name: DR. SIDNEY EVAN WANETICK, MD
Classification: Obstetrics & Gynecology - 207VG0400X
Entity Type: Individual

Specialization: Gynecology

Address:
19845 LAKE CHABOT RD
STE 302
CASTRO VALLEY, CA
ZIP 94546
Phone: (510) 886-3400
Get Directions

DR. Sidney Evan Wanetick, MD is a gynecology obstetrics gynecology in Castro Valley, CA. The provider is a physician who specializes in diagnosis, treatment, and management of patients with gynecologic conditions. Source: National Uniform Claim Committee DR. Sidney Evan Wanetick, MD NPI is 1508869868. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

19845 LAKE CHABOT RD
STE 302
CASTRO VALLEY, CA
ZIP 94546-055
Phone: (510) 886-3400
Fax: (510) 886-0861

The enumeration date for this NPI number is 5/31/2005 and was last updated on 7/8/2007.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	207VG0400X	Obstetrics & Gynecology	Gynecology	G46693	CALIFORNIA	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	G46693	OTHER	CALIFORNIA	STATE MEDICAL LICENSE
2	A50464	MEDICARE UPIN	CALIFORNIA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

NPI Synchronization or Removal

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