Healthcare Provider Details

I. General information

NPI: 1811219579
Provider Name (Legal Business Name): ALAN CURTIS WANDS PA
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/23/2010
Last Update Date: 08/27/2020
Certification Date: 08/27/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

995 POTRERO AVE # WARD83
SAN FRANCISCO CA
94110-2859
US

IV. Provider business mailing address

995 POTRERO AVE # WARD83
SAN FRANCISCO CA
94110-2859
US

V. Phone/Fax

Practice location:
  • Phone: 628-206-5252
  • Fax: 628-206-7505
Mailing address:
  • Phone: 628-206-5252
  • Fax: 628-206-7505

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License NumberPA16974
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: