Individual
BARRY LEE WADDELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
751 S BASCOM AVE, ANESTHESIOLOGY DEPARTMENT, SAN JOSE, CA 95128-2604
(408) 885-5745
Mailing address
PO BOX 5280, PATIENT BUSIENSS SERVICES, SAN JOSE, CA 95150-5280
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
A83161
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00A831610
—
CA
Enumeration date
04/10/2006
Last updated
01/22/2010
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