Paul Wender, M.D.

Individual provider Active NPI Anesthesiology Physician · San Mateo, CA

NPI 1396707485 · NPPES record last updated Aug 17, 2015

Key facts

NPI
1396707485
Entity type
Individual (NPI type 1)
Primary specialty
Anesthesiology Physician 207L00000X
License
G76861 (CA)
Practice address
Abj Surgery Center
104 St Matthews Ave
San Mateo, CA 94401
Phone
(415) 637-9956
Fax
(415) 681-3641
NPI assigned
Apr 4, 2006
Sex
Male
Sole proprietor
Yes

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
Yes
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
76861CAMDPharmacist
G76861CAMDAnesthesiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Bay Area Ketamine Center, Inc. Current Accepting new patients
Paul Edward Wender MD Anesthesiology Past
since Jan 20, 2015
Accepting new patients
Forest Anesthesia Medical Group Inc Anesthesiology Past Accepting new patients

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology Physician 207L00000X G76861 CA Yes

Addresses

Primary practice location

Abj Surgery Center
104 St Matthews Ave
San Mateo, CA 94401

Mailing address

PO Box 22545
San Francisco, CA 94122-0545
Phone (415) 637-9956

Other providers in San Mateo, CA

All providers in San Mateo, CA · Anesthesiology Physician in California

Sources for this page

Verify at the official NPI Registry.