Provider Demographics
NPI:1396707485
Name:WENDER, PAUL (MD)
Entity type:Individual
Prefix:DR
First Name:PAUL
Middle Name:
Last Name:WENDER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 22545
Mailing Address - Street 2:
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94122-0545
Mailing Address - Country:US
Mailing Address - Phone:415-637-9956
Mailing Address - Fax:415-681-3641
Practice Address - Street 1:ABJ SURGERY CENTER
Practice Address - Street 2:104 ST MATTHEWS AVE
Practice Address - City:SAN MATEO
Practice Address - State:CA
Practice Address - Zip Code:94401
Practice Address - Country:US
Practice Address - Phone:415-637-9956
Practice Address - Fax:415-681-3641
Is Sole Proprietor?:Yes
Enumeration Date:2006-04-04
Last Update Date:2015-08-17
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CAG76861207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAG68610Medicare UPIN
CA00G768613Medicare ID - Type Unspecified