Individual
WANDA HEFFERNON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
2360 SCOUT RD, OAKLAND, CA 94611-2724
(415) 672-9861
Mailing address
2360 SCOUT RD, OAKLAND, CA 94611-2724
(415) 672-9861
Taxonomy
Speciality
Code
Description
License number
State
208D00000X
General Practice Physician
Primary
G81259
CA
Other
Enumeration date
06/25/2015
Last updated
06/25/2015
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