Active NPI
Oscar Wand, M.D.
- Ophthalmology Physician
- Portola Valley, CA
National Provider Identifier
1700944154
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Ophthalmology Physician
- License
- G12319
- Practice address
- 65 Valencia CT
Portola Valley, CA 94028-7923 - Phone
- (650) 851-1858
- NPI assigned
- Dec 5, 2006
- Sex
- Male
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Ophthalmology Physician | 207W00000X | G12319 | CA | Primary |
Addresses
Primary practice location
65 Valencia CT
Portola Valley, CA 94028-7923
Mailing address
65 Valencia CT
Portola Valley, CA 94028-7923
Phone (650) 851-1858
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| G12919 | Other | CA | MEDICAL LICENSE |
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
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| G12319 | CA | MD | Ophthalmology Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1165276800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1700944154",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "65 VALENCIA CT",
"city": "PORTOLA VALLEY",
"state": "CA",
"postal_code": "940287923",
"telephone_number": "650-851-1858"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "65 VALENCIA CT",
"city": "PORTOLA VALLEY",
"state": "CA",
"postal_code": "940287923",
"telephone_number": "650-851-1858"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WAND",
"first_name": "OSCAR",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-12-05",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "207W00000X",
"taxonomy_group": "",
"desc": "Ophthalmology",
"state": "CA",
"license": "G12319",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MEDICAL LICENSE",
"identifier": "G12919",
"state": "CA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Portola Valley, 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.