JACOB O WARDWELL


Address: 450 Sutter St Rm 1341, San Francisco, CA 94108-4007
Phone: 4156060309

JACOB O WARDWELL (NPI# 1063723781) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1063723781
Entity Type Individual
Full Name JACOB O WARDWELL
Credential DO
Practice Address 450 Sutter St Rm 1341
San Francisco
CA 94108-4007
Practice Telephone 4156060309
Practice Fax Number 4158620626
Mailing Telephone 4156060309
Mailing Fax Number 4158620626
Enumeration Date 2010-06-28
Last Update Date 2018-02-21
Gender Code M
Is Sole Proprietor N

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 207QS0010X Family Medicine
Specialization: Sports Medicine
12776 CA Allopathic & Osteopathic Physicians

Provider Secondary Practice Location

Address Telephone Number Fax Number
Three Embarcadero Center, Lobby Level, San Francisco, CA 94111 4154952225 4154942228

Office Location

Street Address 450 SUTTER ST RM 1341
City SAN FRANCISCO
State CA
Zip Code 94108-4007

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1831424464 Kara Mosesso Nurse Practitioner 445 Bush St Ste 300, San Francisco, CA 94108 2009-10-15
1043451503 Brandon Valor Brodt Pharmacist 450 Sutter St., Suite 713, San Francisco, CA 94108 2009-03-13
1194983312 L Todd Iverson Dentist 450 Sutter St #2005, San Francisco, CA 94108 2008-05-23
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Taxonomy Information

Taxonomy Code 207QS0010X
Grouping Allopathic & Osteopathic Physicians
Classification Family Medicine
Specialization Sports Medicine

Taxonomy Definition

A family medicine physician that is trained to be responsible for continuous care in the field of sports medicine, not only for the enhancement of health and fitness, but also for the prevention of injury and illness. A sports medicine physician must have knowledge and experience in the promotion of wellness and the prevention of injury. Knowledge about special areas of medicine such as exercise physiology, biomechanics, nutrition, psychology, physical rehabilitation, epidemiology, physical evaluation, injuries (treatment and prevention and referral practice) and the role of exercise in promoting a healthy lifestyle are essential to the practice of sports medicine. The sports medicine physician requires special education to provide the knowledge to improve the health care of the individual engaged in physical exercise (sports) whether as an individual or in team participation.
Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source; 7/1/2011: modified source]
- Additional Resources: American Board of Family Medicine, 2007. http://www.theabfm.org/. American Osteopathic Board of Family Medicine, 2007. http://www.osteopathic.org/certification
- Board certification for Medical Doctors (MDs) is provided by the American Board of Family Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Family Medicine.

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1790701225 Kristin A Wingfield Family Medicine 900 Hyde St, 11th Floor, San Francisco, CA 94109-4806 2006-07-15
1801848270 Anthony C Luke Family Medicine 1701 Divisadero St, San Francisco, CA 94143-0001 2006-05-16

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Competitor

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City SAN FRANCISCO
Zip Code 94108

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Dataset Information

Data Provider Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES)
Jurisdiction Medicare & Medicaid

This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.

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