Eric Walter Widera, M.D.

Primary specialty

Geriatric Medicine (Internal Medicine) PhysicianTaxonomy code 207RG0300X

License

A 92319 Issued in CA

Practice address

4150 Clement St # 181NH
San Francisco, CA 94121-1545

Phone

(415) 221-4810

NPI assigned

Aug 21, 2006

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1156118400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1124134309",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "90 PARKER AVE APT 205",
            "city": "SAN FRANCISCO",
            "state": "CA",
            "postal_code": "941182657",
            "telephone_number": "415-221-4810"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4150 CLEMENT ST # 181NH",
            "city": "SAN FRANCISCO",
            "state": "CA",
            "postal_code": "941211545",
            "telephone_number": "415-221-4810"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WIDERA",
        "first_name": "ERIC",
        "middle_name": "WALTER",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-21",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RG0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Geriatric Medicine",
            "state": "CA",
            "license": "A 92319",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jane Marie Wickman, NP
• Induni Asoka Wickramasinghe
• Tinisha Wicks
• Michael Christian Resayo Wico
• Cheryl A Widdis, DDS
• Laurensia Hermy Widyastami, AGNP-BC
• Lou Ann Wieand, PH.D.
• Katherine Wiebe, PH.D.
• Eckehart Wiedemann, M.D.
• Neil Wiegand, PA-C

• Geriatric Medicine (Internal Medicine) Physician in San Francisco, CA
• Providers in San Francisco, CA by specialty
• Geriatric Medicine (Internal Medicine) Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.