Jack Waxman is a Rheumatology in Santa Rosa, California. Jack Waxman practices all healthcare services and medical treatments related to Rheumatology. The NPI Number for Jack Waxman is 1104824994. The last update date is 2019-01-11.
Jack Waxman's current location address is 1701 4th St Ste 210, Santa Rosa, California. You can contact this provider via phone number 7075736942 and fax number 7075756038. The mailing address for Jack Waxman is 1701 4th St Ste 210, Santa Rosa, California. To know further, please read the information below!
Provider Profile Detail
| Provider Name | Jack Waxman |
|---|---|
| Address | 1701 4th St Ste 210, Santa Rosa, California |
| Phone Number | 7075736942 |
| Fax Number | 7075756038 |
| Sole Proprietor | N |
| Credentials | M.D. |
NPI Number Detail
| NPI Number | 1104824994 |
|---|---|
| Provider Enumeration Date | 2005-07-14 |
| Last Updated Date | 2019-01-11 |
Provider Mailing Address Detail
| Address | 1701 4th St Ste 210 |
|---|---|
| City | Santa Rosa |
| State | California (CA) |
| Post Code | 9540436610 |
| Phone Number | 7075736942 |
| Fax Number | 7075756038 |
Provider's Primary Taxonomy Detail
| Speciality | Rheumatology |
|---|---|
| Taxonomy | 207Rr0500X |
| Licence No | G23398 |
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Definition: An internist who treats diseases of joints, muscle, bones and tendons. This specialist diagnoses and treats arthritis, back pain, muscle strains, common athletic injuries and "collagen" diseases. |
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Provider's Other Legacy Identifiers
| Identifier | Identifier Type | Identifier State | Identifier Issuer |
|---|---|---|---|
| 00G233980 | CA | BLUE SHIELD OF CALIFORNIA | |
| 660002485 | CA | RAILROAD MEDICARE | |
| 00G233980 | CA | -- |
Post Comment/ Review Below
What is the unique provider identifier assigned to Jack Waxman?
The Jack Waxman has been issued the NPI (National Provider Identifier) 1104824994 by the Centers for Medicare & Medicaid Services (CMS). This 10-digit code is a unique identification number for healthcare providers.
Could you kindly provide the complete physical address where Jack Waxman's facilities are geographically located?
The facilities of Jack Waxman are physically situated at the following location: 1701 4Th St Ste 210, Santa Rosa, CA, 9540436610.
What is Jack Waxman's primary area of medical expertise, and what taxonomy classification code corresponds to this specialized field?
The primary area of medical expertise for Jack Waxman is Rheumatology, and the corresponding taxonomy classification code for this specialized field is 207Rr0500X.
When was the Jack Waxman's 1104824994 issued?
The Jack Waxman's 1104824994 was issued on 2005-07-14.
When was the information pertaining to Jack Waxman most recently updated or revised?
The details related to Jack Waxman, including its address, specialty, and other relevant information, were last updated or revised on 2019-01-11.