DR. ELLIOTT LYLE WENGER (NPI# 1346285780) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1346285780 |
| Entity Type | Individual |
| Full Name | DR. ELLIOTT LYLE WENGER |
| Credential | DPM |
| Practice Address |
2929 Summit St 101 Oakland CA 94609-3423 |
| Mailing Address |
6425 Oakwood Dr Oakland CA 94611-1350 |
| Practice Telephone | 5108323137 |
| Practice Fax Number | 5103380760 |
| Mailing Telephone | 5108323137 |
| Mailing Fax Number | 5103380760 |
| Enumeration Date | 2006-06-19 |
| Last Update Date | 2017-01-05 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 213E00000X | Podiatrist | E1759 | CA | Podiatric Medicine & Surgery Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| CA | 000E17590 | 05 | |
| CA | 000E17591 | 05 |
| Street Address |
2929 SUMMIT ST 101 |
| City | OAKLAND |
| State | CA |
| Zip Code | 94609-3423 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1245785526 | Holistic Animal Clinic | Acupuncturist | 2929 Summit St, Suite 102, Oakland, CA 94609-3423 | 2016-08-17 |
| 1629488093 | Elisa Kim | Acupuncturist | 2929 Summit St, Ste. 102, Oakland, CA 94609-3423 | 2014-05-06 |
| 1740534569 | Graham Quigley | Acupuncturist | 2929 Summit St, Suite 102, Oakland, CA 94609-3423 | 2012-10-31 |
| 1427328327 | Adeline Wood | Chiropractor | 2929 Summit St, 102, Oakland, CA 94609-3423 | 2012-01-09 |
| 1508055625 | Nichole Flunder | Acupuncturist | 2929 Summit St, 103, Oakland, CA 94609-3423 | 2007-10-15 |
| 1891907150 | Alfred J Reynaud | Clinical Medical Laboratory | 2929 Summit St, #208, Oakland, CA 94609 | 2007-05-07 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1104457159 | Gerard John-charles Coughlin | Student in an Organized Health Care Education/Training Program | Samuel Merritt University, 3100 Telegraph Avenue, Oakland, CA 94609 | 2020-01-29 |
| 1417502022 | Michael Knittel | Registered Nurse | 370 Hawthorne Ave, Oakland, CA 94609 | 2019-08-09 |
| 1962057562 | Nicole Kjolby | Registered Nurse | Samuel Merritt College, 370 Hawthorne Ave, Oakland, CA 94609 | 2019-08-09 |
| 1396208286 | Graham Vallis | Student in an Organized Health Care Education/Training Program | Ucsf Benioff Children's Hospital Oakland, 747 52nd Street, Oakland, CA 94609 | 2019-04-09 |
| 1386129526 | Gary Mitchell Snider | Counselor | 390 40th Street, Oakland, CA 94609 | 2018-10-02 |
| 1720568389 | Lice Control Inc. | Technician | 6557 Shattuck Ave, Oakland, CA 94609 | 2018-08-14 |
| 1528559150 | Jenna Marie Kincaid | Behavior Technician | 400 29th St., 204, Oakland, CA 94609 | 2018-05-18 |
| 1336656669 | Nicholas Dicarlo | Social Worker | 465 34th St Ste 6, Oakland, CA 94609 | 2018-01-09 |
| 1174045744 | Theodora J Marzouk | Home Health Aide | 3317 Elm Street, Suite 202, Oakland, CA 94609 | 2017-07-14 |
| 1740728922 | Elena Gardella | Marriage & Family Therapist | 411 30th Street, Suite 412, Oakland, CA 94609 | 2017-02-07 |
| Find all providers in zip 94609 | ||||
| Taxonomy Code | 213E00000X |
| Grouping | Podiatric Medicine & Surgery Service Providers |
| Classification | Podiatrist |
| A podiatrist is a person qualified by a Doctor of Podiatric Medicine (D.P.M.) degree, licensed by the state, and practicing within the scope of that license. Podiatrists diagnose and treat foot diseases and deformities. They perform medical, surgical and other operative procedures, prescribe corrective devices and prescribe and administer drugs and physical therapy. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1568620169 | Timothy J Hart, Dpm, PC | Podiatrist | 1376 Broncos Hwy, Oakland, RI 02858-1000 | 2008-05-30 |
| 1184747479 | Cimaglia Foot Care, Pllc | Podiatrist | 311 North 4th Street, Suite 4, Oakland, MD 21550-1371 | 2007-04-09 |
| 1366556276 | Podiatric Health Associates, P.C. | Podiatrist | 6 Franklin Ave, Oakland, NJ 07436-3420 | 2006-08-18 |
| 1518979996 | Alan Friedman | Podiatrist | 2109 Macarthur Blvd, Oakland, CA 94602 | 2006-08-13 |
| 1568476000 | Kam Yuen Wong | Podiatrist | 400 30th St Suite 403, Oakland, CA 94609-3305 | 2006-07-28 |
| 1154314011 | Dennis J Lyons | Podiatrist | 4247 Mac Arthur Blvd., Oakland, CA 94619-1907 | 2005-08-25 |
| 1255339511 | Cathy A Cimaglia | Podiatrist | 311 N 4th St Ste 4, Oakland, MD 21550-1371 | 2005-07-11 |
| 1912442435 | Propel Foot and Ankle Institute | Podiatrist | 2961 Summit St Ste B, Oakland, CA 94609-3482 | 2016-12-20 |
| 1497012777 | Nicholas V Drbal | Podiatrist | 350 30th St, Suite 100, Oakland, CA 94609-3424 | 2012-04-11 |
| 1801080213 | Cimaglia Foot Care Pllc | Podiatrist | 311 North 4th Street, Suite 4, Oakland, MD 21550-1371 | 2007-08-29 |
| Find all providers in OAKLAND | ||||
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| 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.