MEDICARE: DON H WASSERMAN MD LTD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	208800000X	Urology Physician	G10754	CA

General Provider Information

NPI Number	:	1053566554
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	DON H WASSERMAN MD LTD

Provider Business Mailing Address
First Line	:	370 DEL NORTE AVE
Second Line	:	STE 204
City	:	YUBA CITY
State	:	CA
Zip	:	95991
Country	:	US
Telephone Number	:	530-751-4730
Fax Number	:	530-751-4793

Provider Business Practice Location Address
First Line	:	370 DEL NORTE AVE
Second Line	:	STE 204
City	:	YUBA CITY
State	:	CA
Zip	:	95991-4142
Country	:	US
Telephone Number	:	530-751-4730
Fax Number	:	530-751-4793

Authorized Official
Title or Position	:	OWNER
Name	:	DR. DON H WASSERMAN
Credential	:	MD
Telephone Number	:	530-751-4730

Provider Enumeration Date	:	11/25/2008
Last Update Date	:	11/25/2008

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