Provider Demographics
NPI:1285084723
Name:WALDMAN, WENDY KIM (MD)
Entity type:Individual
Prefix:
First Name:WENDY
Middle Name:KIM
Last Name:WALDMAN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:WENDY
Other - Middle Name:JISOO
Other - Last Name:KIM
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:421 N RODEO DR PH 1
Mailing Address - Street 2:
Mailing Address - City:BEVERLY HILLS
Mailing Address - State:CA
Mailing Address - Zip Code:90210-4531
Mailing Address - Country:US
Mailing Address - Phone:310-432-6640
Mailing Address - Fax:
Practice Address - Street 1:421 N RODEO DR PH 1
Practice Address - Street 2:
Practice Address - City:BEVERLY HILLS
Practice Address - State:CA
Practice Address - Zip Code:90210-4531
Practice Address - Country:US
Practice Address - Phone:310-432-6640
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-06-15
Last Update Date:2020-08-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA0207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology