Individual
DR. WILFRED WALTER EASTMAN JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D/
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
00G396230
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1437129939
—
CA
01
—
200018580
MEDICARE RAILROAD
CA
01
—
CJ570Z
PTAN
CA
01
—
CMS116890
MTC CONSULTANT
CA
05
—
CMS116890
—
CA
Enumeration date
01/25/2006
Last updated
11/17/2009
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