Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RG0100X | Gastroenterologist | A145736 | CA |
NPI | 1003234501 |
---|---|
Provider Name | Sanya Wadhwa |
First Address | Concord, CA 94520-2066 |
Second Address | Concord, CA 94520-2066 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 01/04/2014 |
Last Update Date | 28/07/2020 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
A145736 | MEDICAL LICENSE (01) | CA |