Organization
VITREO-RETINAL MEDICAL GROUP, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ROBERT T. WENDEL MD (PRESIDENT)
(916) 453-5450
Entity
Organization
Contact information
Practice address
3939 J ST STE 104, SACRAMENTO, CA 95819-3631
(916) 453-5450
(916) 454-1015
Mailing address
3939 J ST STE 104, SACRAMENTO, CA 95819-3631
(916) 453-5450
(916) 454-1015
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
199873
DEPT. OF LABOR WA
WA
01
—
CP5300
RAILROAD MEDICARE
CA
05
—
GR0030320
—
CA
05
—
GR0030321
—
CA
05
—
GR0030322
—
CA
05
—
GR0030323
—
CA
Enumeration date
12/18/2006
Last updated
01/25/2008
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