Active NPI
Cristian J Wedekind, CCP
- Perfusionist
- Fremont, CA
National Provider Identifier
1598987828
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Perfusionist
- License
- 810111-1120
- Practice address
- 2000 Mowry Ave
Fremont, CA 94538-1716 - Phone
- (650) 322-4222
- Fax
- (650) 322-4222
- NPI assigned
- May 3, 2007
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Perfusionist | 242T00000X | 810111-1120 | Primary |
Addresses
Primary practice location
2000 Mowry Ave
Fremont, CA 94538-1716
Mailing address
PO Box 1374
Menlo Park, CA 94026-1374
Phone (650) 322-4222
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 810111-1120 | Other | AMER BOARD CV PERFUSION |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1178150400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1598987828",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 1374",
"city": "MENLO PARK",
"state": "CA",
"postal_code": "940261374",
"telephone_number": "650-322-4222",
"fax_number": "650-322-4222"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2000 MOWRY AVE",
"city": "FREMONT",
"state": "CA",
"postal_code": "945381716",
"telephone_number": "650-322-4222",
"fax_number": "650-322-4222"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WEDEKIND",
"first_name": "CRISTIAN",
"middle_name": "J",
"name_prefix": "Mr.",
"credential": "CCP",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2007-05-03",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "242T00000X",
"taxonomy_group": "",
"desc": "Perfusionist",
"state": null,
"license": "810111-1120",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "AMER BOARD CV PERFUSION",
"identifier": "810111-1120",
"state": null
}
],
"endpoints": [],
"other_names": []
}Other providers in Fremont, CA
Sources for this page
- 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.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.