Individual
ROBERT T WANKMULLER JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
945 SHASTA ST, YUBA CITY, CA 95991-4114
(530) 671-8564
(530) 671-8592
Mailing address
945 SHASTA ST, YUBA CITY, CA 95991-4114
(530) 645-5338
(530) 645-5358
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
G74319
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00G743190
—
CA
01
—
300035246
RAILROAD MEDICARE
—
01
—
300129511
MEDICARE ID
—
Enumeration date
01/05/2006
Last updated
04/18/2017
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