Individual
LAWRENCE WANETICK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D. F.A.C.S.
Contact information
Practice address
1776 YGNACIO VALLEY RD, SUITE 102, WALNUT CREEK, CA 94598-3190
(925) 280-0800
(925) 944-3338
Mailing address
1776 YGNACIO VALLEY RD, SUITE 102, WALNUT CREEK, CA 94598-3190
(925) 280-0800
(925) 944-3338
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
G13201
CA
Other
Enumeration date
10/16/2006
Last updated
06/16/2010
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