| Dr David E Wanderman, MD | |
|
1720 El Camino Real Ste 205, Burlingame, CA 94010-3226 | |
| (650) 259-5050 | |
| (650) 697-1317 |
| Full Name | Dr David E Wanderman |
|---|---|
| Gender | Male |
| Speciality | Pediatrics |
| Location | 1720 El Camino Real Ste 205, Burlingame, California |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1770517732 | NPI | - | NPPES |
| 00A908330 | Medicaid | CA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 208000000X | Pediatrics | A90833 (California) | Primary |
| Entity Name | Lpch Medical Group Div Of Lucile |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1417907940 PECOS PAC ID: 0840298543 Enrollment ID: O20061113000232 |
| Mailing Address | Practice Location Address |
|---|---|
| Dr David E Wanderman, MD 1720 El Camino Real Ste 205, Burlingame, CA 94010-3226 Ph: (650) 259-5050 | Dr David E Wanderman, MD 1720 El Camino Real Ste 205, Burlingame, CA 94010-3226 Ph: (650) 259-5050 |
Dr. Tara Tanaka, M.D. Pediatrics Medicare: Medicare Enrolled Practice Location: 1720 El Camino Real Ste 205, Burlingame, CA 94010 Phone: 650-259-5050 | |
Karin K. Wertz, MD Pediatrics Medicare: Medicare Enrolled Practice Location: 1501 Trousdale Dr, Burlingame, CA 94010 Phone: 650-652-8720 | |
Jennifer Lynn Carlson, MD Pediatrics Medicare: Medicare Enrolled Practice Location: 225 California Dr, Burlingame, CA 94010 Phone: 415-353-2002 | |
Debra A Barra-stevens, MD Pediatrics Medicare: Not Enrolled in Medicare Practice Location: 1501 Trousdale Dr, Burlingame, CA 94010 Phone: 650-652-8720 | |
Dr. Eric Perez, MD Pediatrics Medicare: Medicare Enrolled Practice Location: 1501 Trousdale Dr, Burlingame, CA 94010 Phone: 650-652-8720 | |
Marie Elizabeth Ribeiro, MD Pediatrics Medicare: Accepting Medicare Assignments Practice Location: 1501 Trousdale Dr, Burlingame, CA 94010 Phone: 650-652-8720 | |
Dr. Laurie Yang Marsh, M.D. Pediatrics Medicare: Not Enrolled in Medicare Practice Location: 1720 El Camino Real, Burlingame, CA 94010 Phone: 650-259-5050 |