Wandisan and Rosete Medical Group Professional Corporation

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

A72169 Issued in CA

Legal business name

WANDISAN AND ROSETE MEDICAL GROUP PROFESSIONAL CORPORATION

Practice address

4600 S Tracy Blvd #107
Tracy, CA 95377

Phone

(209) 836-4920

Fax

(209) 836-4935

NPI assigned

Aug 31, 2006

Organization subpart

No

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

Authorized official

Name

Florence Wandisan Rosete, M.D

Title

Cfo

Phone

(209) 836-4920

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Florence Leguiab Wandisan-Rosete, MD

  • Internal Medicine Physician
  • Tracy, CA
  • NPI 1457396897
  Medicare reassignment NPD

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

{
    "created_epoch": "1156982400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1531180800000",
    "number": "1316058795",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4600 S TRACY BLVD #107",
            "city": "TRACY",
            "state": "CA",
            "postal_code": "95377",
            "telephone_number": "209-836-4920",
            "fax_number": "209-836-4935"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4600 S TRACY BLVD #107",
            "city": "TRACY",
            "state": "CA",
            "postal_code": "95377",
            "telephone_number": "209-836-4920",
            "fax_number": "209-836-4935"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WANDISAN AND ROSETE MEDICAL GROUP PROFESSIONAL CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-31",
        "last_updated": "2018-07-10",
        "status": "A",
        "authorized_official_last_name": "ROSETE",
        "authorized_official_first_name": "FLORENCE",
        "authorized_official_middle_name": "WANDISAN",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "209-836-4920",
        "authorized_official_credential": "M.D"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine",
            "state": "CA",
            "license": "A72169",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Gursimran Singh Walia
• Walmart Inc.
• Walmart Stores, Inc.
• Tyliah Walters
• Christopher Scott Walthour, MD
• Florence Leguiab Wandisan-Rosete, MD
• Puneet Waraich
• Angela Michelle Ward
• Jazmyn Olivia Ward
• Kelly Elizabeth Ward, MS

• Internal Medicine Physician in Tracy, CA
• Providers in Tracy, CA by specialty
• Internal Medicine Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 10, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.