Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 208200000X | Surgeon | C54296 | CA |
N | 208600000X | Surgeon | C54296 | CA |
Y | 2086S0120X | Pediatric Surgery | 19504 | NV |
N | 2086S0120X | Pediatric Surgery | C54296 | CA |
N | 2086S0120X | Pediatric Surgery | MD2016-0814 | NM |
NPI | 1548461346 |
---|---|
Provider Name | Wolfgang Stehr |
First Address | Oakland, CA 94609-1810 |
Second Address | Oakland, CA 94609-1810 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 30/05/2007 |
Last Update Date | 27/01/2022 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
12146131 | CAQH (01) | NV |
19504 | MD NEVADA (01) | NV |
C54296 | MD CALI (01) | CA |