Healthcare Provider Details

I. General information

NPI: 1275723892
Provider Name (Legal Business Name): WENDY FLAPAN D.O., INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/30/2007
Last Update Date: 07/30/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

333 OCONNOR DR
SAN JOSE CA
95128-1623
US

IV. Provider business mailing address

333 OCONNOR DR
SAN JOSE CA
95128-1623
US

V. Phone/Fax

Practice location:
  • Phone: 408-297-3484
  • Fax:
Mailing address:
  • Phone: 408-297-3484
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2081S0010X
TaxonomySports Medicine (Physical Medicine & Rehabilitation) Physician
License Number20A8080
License Number StateCA

VIII. Authorized Official

Name: DR. WENDY FLAPAN
Title or Position: PHYSICIAN
Credential:
Phone: 916-730-1833