Wendell Mark Street, M.D., Inc

Primary specialty

Pain Medicine (Anesthesiology) PhysicianTaxonomy code 207LP2900X

License

A43837 Issued in CA

Legal business name

WENDELL MARK STREET, M.D., INC

Practice address

11332 Mountain View Ave
Suite a
Loma Linda, CA 92354-3854

Phone

(951) 640-1230

Fax

(951) 924-2535

NPI assigned

Feb 4, 2008

Organization subpart

No

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

Authorized official

Name

Dr. Wenell Mark Street, M.D.

Title

Owner/Medical Director

Phone

(951) 640-1230

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1202083200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1202083200000",
    "number": "1902084783",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17868 US HIGHWAY 18",
            "city": "APPLE VALLEY",
            "state": "CA",
            "postal_code": "923071267",
            "telephone_number": "951-640-1230",
            "fax_number": "951-924-2535"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11332 MOUNTAIN VIEW AVE",
            "address_2": "SUITE A",
            "city": "LOMA LINDA",
            "state": "CA",
            "postal_code": "923543854",
            "telephone_number": "951-640-1230",
            "fax_number": "951-924-2535"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WENDELL MARK STREET, M.D., INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-02-04",
        "last_updated": "2008-02-04",
        "status": "A",
        "authorized_official_last_name": "STREET",
        "authorized_official_first_name": "WENELL",
        "authorized_official_middle_name": "MARK",
        "authorized_official_title_or_position": "OWNER/MEDICAL DIRECTOR",
        "authorized_official_telephone_number": "951-640-1230",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207LP2900X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Anesthesiology, Pain Medicine",
            "state": "CA",
            "license": "A43837",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Svetlana Welebir, CRNA
• Ryan Weller, RDHAP
• Wellhouse Care, Inc.
• Marian Elizabeth Wells, PNP
• Elizabeth Welsh, PH.D.
• Joshua Eric Wendt, MD
• Szu-Han Weng, DDS
• Roger Scott Jacob Wenger, PSY.D.
• Asher Zachary Wenig
• Kevin Wenzel, PH.D.

• Pain Medicine (Anesthesiology) Physician in Loma Linda, CA
• Providers in Loma Linda, CA by specialty
• Pain Medicine (Anesthesiology) Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 4, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.