Individual
DR. SIDNEY EVAN WANETICK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
19845 LAKE CHABOT RD, STE 302, CASTRO VALLEY, CA 94546-4055
(510) 886-3400
(510) 886-0861
Mailing address
7 BUTLER DR, LAFAYETTE, CA 94549-3358
(925) 283-9420
(925) 283-6518
Taxonomy
Speciality
Code
Description
License number
State
207VG0400X
Gynecology Physician
Primary
G46693
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
G46693
STATE MEDICAL LICENSE
CA
Enumeration date
05/31/2005
Last updated
07/13/2026
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