| Stacy Leigh Waneka Md Pc | |
|
2475 Townsgate Rd Ste 200 Westlake Village CA 91361-5995 | |
| (818) 338-2540 | |
| (818) 338-1498 |
| Full Name | Stacy Leigh Waneka Md Pc |
|---|---|
| Speciality | Family Medicine |
| Location | 2475 Townsgate Rd Ste 200, Westlake Village, California |
| Authorized Official Name and Position | Stacy Waneka (PRESIDENT) |
| Authorized Official Contact | 3102703800 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Stacy Leigh Waneka Md Pc 5340 Las Virgenes Rd Apt 7 Calabasas CA 91302-2693 Ph: (310) 270-3800 | Stacy Leigh Waneka Md Pc 2475 Townsgate Rd Ste 200 Westlake Village CA 91361-5995 Ph: (818) 338-2540 |
| NPI Number | 1811622624 |
|---|---|
| Provider Enumeration Date | 07/18/2022 |
| Last Update Date | 08/19/2024 |
| Medicare PECOS PAC ID | 2466835400 |
|---|---|
| Medicare Enrollment ID | O20220824000181 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1811622624 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
| Provider Name | Stacy L Waneka |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1871557546 PECOS PAC ID: 8022920321 Enrollment ID: I20031104000704 |
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