Healthcare Provider Details

I. General information

NPI: 1023132289
Provider Name (Legal Business Name): WENDY DAUER M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/16/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

15215 LEFFINGWELL RD
WHITTIER CA
90604-2254
US

IV. Provider business mailing address

15215 LEFFINGWELL RD
WHITTIER CA
90604-2254
US

V. Phone/Fax

Practice location:
  • Phone: 562-946-9696
  • Fax: 562-946-9644
Mailing address:
  • Phone: 562-946-9696
  • Fax: 562-946-9644

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberG59129
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: