Justin Wahlstrom, M.D.

Primary specialty

Pediatric Hematology & Oncology PhysicianTaxonomy code 2080P0207X

License

A113418 Issued in CA

Practice address

505 Parnassus Ave
San Francisco, CA 94143-2204

Phone

(415) 443-4127

NPI assigned

May 31, 2008

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Interoperability endpoints

• Direct secure messaging: jwahlstrom14128@direct-ucsfmedicalcenter.org

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

{
    "created_epoch": "1212192000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1334275200000",
    "number": "1912165358",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "505 PARNASSUS AVE",
            "address_2": "BOX 0106",
            "city": "SAN FRANCISCO",
            "state": "CA",
            "postal_code": "941432204",
            "telephone_number": "415-823-2246"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "505 PARNASSUS AVE",
            "city": "SAN FRANCISCO",
            "state": "CA",
            "postal_code": "941432204",
            "telephone_number": "415-443-4127"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WAHLSTROM",
        "first_name": "JUSTIN",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2008-05-31",
        "last_updated": "2012-04-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2080P0207X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Hematology-Oncology",
            "state": "NY",
            "license": "240540",
            "primary": false
        },
        {
            "code": "2080P0207X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Hematology-Oncology",
            "state": "CA",
            "license": "A113418",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Galen W. Wagnild, D.D.S.
• Amanda Wagstaff, PH.D.
• Connie Wahl
• Elizabeth Rachel Wahl, M.D.
• Kaitlin Wahl
• Sandino Wahpepah
• Jennifer D Wahr
• Wai Cheung DDS P.C.
• Wai-Lam Chan MD Inc
• Ching Ching Wai

• Pediatric Hematology & Oncology Physician in San Francisco, CA
• Providers in San Francisco, CA by specialty
• Pediatric Hematology & Oncology Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 13, 2012; 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.