DR. SIDNEY EVAN WANETICK (NPI# 1508869868) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1508869868 |
| Entity Type | Individual |
| Full Name | DR. SIDNEY EVAN WANETICK |
| Credential | MD |
| Practice Address |
19845 Lake Chabot Rd Ste 302 Castro Valley CA 94546-4055 |
| Mailing Address |
7 Butler Dr Lafayette CA 94549-3358 |
| Practice Telephone | 5108863400 |
| Practice Fax Number | 5108860861 |
| Mailing Telephone | 9252839420 |
| Mailing Fax Number | 9252836518 |
| Enumeration Date | 2005-05-31 |
| Last Update Date | 2007-07-08 |
| Gender Code | M |
| Is Sole Proprietor | X |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207VG0400X |
Obstetrics & Gynecology Specialization: Gynecology |
G46693 | CA | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| CA | STATE MEDICAL LICENSE | G46693 | 01 |
| Street Address |
19845 LAKE CHABOT RD STE 302 |
| City | CASTRO VALLEY |
| State | CA |
| Zip Code | 94546-4055 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1780022640 | Joseph A Karam, Md | Specialist | 19845 Lake Chabot Rd, Suite 200, Castro Valley, CA 94546-4055 | 2013-06-12 |
| 1265787659 | Amber Louise Jones | Surgery | 19845 Lake Chabot Rd, Castro Valley, CA 94546-4055 | 2012-07-21 |
| 1982960084 | East Bay Trauma & Acute Care Surgery Inc. | Specialist | 19845 Lake Chabot Rd, 200, Castro Valley, CA 94546-4055 | 2012-04-03 |
| 1043519531 | Vishal Ghevariya | Internal Medicine | 19845 Lake Chabot Rd, Ste 104, Castro Valley, CA 94546-4055 | 2011-03-23 |
| 1083891212 | George D Cowen, Md Professional Corp | Internal Medicine | 19845 Lake Chabot Rd, Suite 211, Castro Valley, CA 94546-4055 | 2008-01-30 |
| 1073707923 | Carolyn Elizabeth Mcaloon | Podiatrist | 19845 Lake Chabot Rd, Suite 301, Castro Valley, CA 94546-4055 | 2007-09-04 |
| 1932325446 | Jeffrey Singerman | Internal Medicine | 19845 Lake Chabot Rd, Suite 104, Castro Valley, CA 94546-4055 | 2007-04-17 |
| 1578696134 | Terence C. Wong, A Professional Dental Corporation | Dentist | 19845 Lake Chabot Rd, Suite #210, Castro Valley, CA 94546-4055 | 2007-03-13 |
| 1336279785 | Sarah H Lindahl | Physician Assistant | 19845 Lake Chabot Rd, Suite #302, Castro Valley, CA 94546-4055 | 2007-03-06 |
| 1326176462 | Terence Chuck Wong | Dentist | 19845 Lake Chabot Rd, Suite #210, Castro Valley, CA 94546-4055 | 2007-03-01 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1861991234 | For Your Eyes Only Ophthalmic Medical Corp. | Optometrist | 2687 Castro Valley Blvd., Castro Valley, CA 94546 | 2018-02-12 |
| 1821536954 | Webster Surgery Center, Lp | Clinic/Center | 20998 Redwood Dr, Castro Valley, CA 94546 | 2017-02-09 |
| 1639506215 | Jennifer Lee | Pharmacist | 20629 Redwood Road, Castro Valley, CA 94546 | 2013-09-27 |
| 1679860506 | Lauren Nicole Hill | Counselor | 20212 Redwood Rd Ste 104, Castro Valley, CA 94546 | 2011-06-29 |
| 1326330952 | Jeannette Villalobos | Counselor | 5248 Crane Avenue, Castro Valley, CA 94546 | 2011-05-16 |
| 1780992560 | Cherie Christine-vivona Clark | Physician Assistant | Eden Emergency Department, 20103 Lake Chabot Road, Castro Valley, CA 94546 | 2010-09-15 |
| 1518287218 | Rite Aid Incorporation | Community/Behavioral Health | 3548 Castro Valley Blv, Castro Valley, CA 94546 | 2010-06-03 |
| 1770719940 | Kristina Marie Sotto | Occupational Therapist | 20259 Lake Chabot Road, Castro Valley, CA 94546 | 2009-06-02 |
| 1861664203 | Bannanje R Nayak | Physical Medicine & Rehabilitation | 19830 Lake Chabot Road, Ste C, Castro Valley, CA 94546 | 2008-03-26 |
| 1205030202 | Yvonne Marie Jones | Social Worker | 2055 Fairmont Dr., San Leandro, CA 94546 | 2007-06-13 |
| Find all providers in zip 94546 | ||||
| Taxonomy Code | 207VG0400X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Obstetrics & Gynecology |
| Specialization | Gynecology |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1013526862 | My Optimal Life | Obstetrics & Gynecology | 72301 Country Club Dr Ste 105, Rancho Mirage, CA 92270-8007 | 2020-07-28 |
| 1740833078 | Lillian Shumate Md | Obstetrics & Gynecology | 1401 Spanos Ct Ste 124, Modesto, CA 95355-2814 | 2019-07-16 |
| 1568927754 | J Kingsley Fife | Obstetrics & Gynecology | 1165 Las Pulgas Pl, Pacific Palisades, CA 90272-2440 | 2019-02-01 |
| 1518457704 | Leon Baginski Md Inc | Obstetrics & Gynecology | 26800 Crown Valley Pkwy Ste 560, Mission Viejo, CA 92691 | 2018-05-14 |
| 1396253340 | Yasharpour Medical Doctor, Inc A Professional Medical Corporation | Obstetrics & Gynecology | 21013 Sherman Way Ste 4, Canoga Park, CA 91303-3675 | 2018-01-11 |
| 1851828222 | Desert Valley Obgyn Inc | Obstetrics & Gynecology | 39000 Bob Hope Dr Ste 303, Rancho Mirage, CA 92270-3221 | 2017-05-17 |
| 1295274660 | Koe Medical Consulting, Inc. | Obstetrics & Gynecology | 5680 Trinidad Way, San Diego, CA 92114-5310 | 2017-02-18 |
| 1518404441 | Women's Health Care Research Corporation | Obstetrics & Gynecology | 3750 Convoy St Ste 311, San Diego, CA 92111-3741 | 2017-01-30 |
| 1730626722 | Aela Paiz Do Inc | Obstetrics & Gynecology | 9620 Clybourn Ave, Sun Valley, CA 91352-1623 | 2017-01-27 |
| 1538521125 | Randal Sloop Md Inc | Obstetrics & Gynecology | 2068 Talbert Dr Ste 150, Chico, CA 95928-7723 | 2016-03-23 |
| Find all providers with the same taxonomy | ||||
| City | CASTRO VALLEY |
| Zip Code | 94546 |
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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.