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General NPI Number Information
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NPI Number | 1780329987
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Entity Type | Individual
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Provider Name | SEAN TRUEMAN WICKERS MD
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Gender | Male
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Dates
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Enumeration Date | 05/02/2022
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Last Update Date | 06/26/2025
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Provider Practice Location Address
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Address Line | 1975 4TH ST
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City | SAN FRANCISCO
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State | CA
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Zip | 94143-2351
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Country | US
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Telephone | 415-476-5190
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Fax |
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Provider Business Mailing Address
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Address Line | 9123 E MISSISSIPPI AVE APT 15-303
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City | DENVER
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State | CO
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Zip | 80247-6882
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208000000X
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Taxonomy Name | Pediatrics Physician
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License Number | A191649
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License Number State | CA
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