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Individual

DR. ROBERT THOMAS WENDEL

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
3939 J ST, SUITE 106, SACRAMENTO, CA 95819-3631
(916) 454-6191
(916) 454-1036
Mailing address
3939 J ST, SUITE 104, SACRAMENTO, CA 95819-3631
(916) 454-6191
(916) 454-1036

Taxonomy

Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
6988
NV
207W00000X
Ophthalmology Physician
G43291
CA
207WX0107X
Retina Specialist (Ophthalmology) Physician
Primary
G043291
CA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
00G432910
BLUE SHIELD
CA
05
00G432910
CA
01
0199874
DEPT. OF LABOR WASHINGTON
WA
01
180009834
RAILROAD MEDICARE
CA
Enumeration date
09/13/2006
Last updated
04/02/2017
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