Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207XS0106X | Orthopaedic Hand Surgeon | G84772 | CA |
NPI | 1114265949 |
---|---|
Provider Name | Dr. Wayne Pan |
First Address | Oakland, CA 94608-2136 |
Second Address | Oakland, CA 94608-2136 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 29/01/2013 |
Last Update Date | 28/09/2021 |