MEDICARE: PATRICK EDWARD WHERRY MD

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	A32798	CA

General Provider Information

NPI Number	:	1134127269
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	PATRICK EDWARD WHERRY MD

Provider Business Mailing Address
First Line	:	2505 SAMARITAN DR
Second Line	:	SUITE 201
City	:	SAN JOSE
State	:	CA
Zip	:	95124-4006
Country	:	US
Telephone Number	:	408-356-7089
Fax Number	:	408-356-0890

Provider Business Practice Location Address
First Line	:	2505 SAMARITAN DR
Second Line	:	SUITE 201
City	:	SAN JOSE
State	:	CA
Zip	:	95124-4006
Country	:	US
Telephone Number	:	408-356-7089
Fax Number	:	408-356-0890

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/12/2005
Last Update Date	:	07/08/2007

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