Healthcare Provider Details

I. General information

NPI: 1003234501
Provider Name (Legal Business Name): SANYA WADHWA M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/01/2014
Last Update Date: 01/02/2024
Certification Date: 01/02/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

300 FRANK H OGAWA PLZ STE 355
OAKLAND CA
94612-2088
US

IV. Provider business mailing address

300 FRANK H OGAWA PLZ STE 355
OAKLAND CA
94612-2088
US

V. Phone/Fax

Practice location:
  • Phone: 510-444-3297
  • Fax: 510-444-6421
Mailing address:
  • Phone: 510-433-7821
  • Fax: 510-433-7831

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number StateNULL
# 2
Primary TaxonomyY
Taxonomy Code207RG0100X
TaxonomyGastroenterology Physician
License NumberA145736
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: