# SHADELANDS ENDOVASCULAR, LLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1245620954
- **Authorized official:** INEZ WONDEH (COO)
- **Authorized official phone:** (925) 378-4500

## Contact information

- **Practice address:** 460 N WIGET LN STE B, WALNUT CREEK, CA 94598-2408
- **Practice address phone:** (925) 627-3495
- **Practice address fax:** (925) 891-4322
- **Mailing address:** 460 N WIGET LN STE B, WALNUT CREEK, CA 94598-2408
- **Mailing address phone:** (925) 627-3495
- **Mailing address fax:** (925) 891-4322

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QA1903X | Ambulatory Surgical Clinic/Center | — | NULL | Yes |

## Other

- **Enumeration date:** 02/02/2015
- **Last updated:** 04/04/2018