Provider Demographics
NPI:1588741433
Name:FLAPAN, WENDY (DO)
Entity type:Individual
Prefix:DR
First Name:WENDY
Middle Name:
Last Name:FLAPAN
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:333 OCONNOR DR
Mailing Address - Street 2:
Mailing Address - City:SAN JOSE
Mailing Address - State:CA
Mailing Address - Zip Code:95128-1623
Mailing Address - Country:US
Mailing Address - Phone:408-297-3484
Mailing Address - Fax:
Practice Address - Street 1:333 OCONNOR DR
Practice Address - Street 2:
Practice Address - City:SAN JOSE
Practice Address - State:CA
Practice Address - Zip Code:95128-1623
Practice Address - Country:US
Practice Address - Phone:408-297-3484
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-10-31
Last Update Date:2010-05-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA20A8080208100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & Rehabilitation
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA020A80800Medicaid
I51170Medicare UPIN
CA020A80800Medicaid