Healthcare Provider Details

I. General information

NPI: 1093881682
Provider Name (Legal Business Name): CALIFORNIA HAND AND WRIST ASSOCIATES,A MEDICAL CORPORATION
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/27/2006
Last Update Date: 03/03/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

104 SAINT MATTHEWS AVE
SAN MATEO CA
94401-2807
US

IV. Provider business mailing address

104 SAINT MATTHEWS AVE
SAN MATEO CA
94401-2807
US

V. Phone/Fax

Practice location:
  • Phone: 650-344-8700
  • Fax: 650-344-8787
Mailing address:
  • Phone: 650-344-8700
  • Fax: 650-344-8787

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2082S0105X
TaxonomySurgery of the Hand (Plastic Surgery) Physician
License NumberG62677
License Number StateCA

VIII. Authorized Official

Name: DR. JAMES L PERTSCH
Title or Position: PRESIDENT
Credential: MD
Phone: 650-344-8700