MEDICARE: DR. SIDNEY EVAN WANETICK 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	207VG0400X	Gynecology Physician	G46693	CA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	G46693	OTHER	CA	STATE MEDICAL LICENSE

General Provider Information

NPI Number	:	1508869868
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. SIDNEY EVAN WANETICK MD

Provider Business Mailing Address
First Line	:	7 BUTLER DR
Second Line	:
City	:	LAFAYETTE
State	:	CA
Zip	:	94549-3358
Country	:	US
Telephone Number	:	925-283-9420
Fax Number	:	925-283-6518

Provider Business Practice Location Address
First Line	:	19845 LAKE CHABOT RD
Second Line	:	STE 302
City	:	CASTRO VALLEY
State	:	CA
Zip	:	94546-4055
Country	:	US
Telephone Number	:	510-886-3400
Fax Number	:	510-886-0861

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

Provider Enumeration Date	:	05/31/2005
Last Update Date	:	07/08/2007

Similar Medicare Providers

1225073588 — VALLEY ASSOCIATED UROLOGY MEDICARE GROUP INC
Practice Location Address:

200 COTTAGE AVE , STE 101
MANTECA, CA
95336-4935

Practice Phone: 209-239-2197
Practice Fax: 209-239-7672

1083850580 — ALAMEDA COUNTY
Practice Location Address:

19845 LAKE CHABOT RD STE 301
CASTRO VALLEY, CA
94546-4055

Practice Phone: 510-667-3270
Practice Fax: 510-481-7615

1457356230 — JOANNE M. SEITZ RNC, NP
Practice Location Address:

19845 LAKE CHABOT RD , STE 302
CASTRO VALLEY, CA
94546-4055

Practice Phone: 510-886-3400
Practice Fax: 510-886-0861

1730177908 — JANE HENDERSON EVERSOLE PT, MA
Practice Location Address:

19845 LAKE CHABOT RD , SUITE 205
CASTRO VALLEY, CA
94546-4055

Practice Phone: 510-538-9558
Practice Fax: 510-538-7017

1114903788 — MR. JEAN-PIERRE LOUIS VIEL PT, DPT, OCS
Practice Location Address:

19845 LAKE CHABOT RD , SUITE 205
CASTRO VALLEY, CA
94546-4055

Practice Phone: 510-538-9558
Practice Fax: 510-538-7017

1356310502 — DR. ZEV M KAHN M.D.
Practice Location Address:

19845 LAKE CHABOT RD , SUITE 302
CASTRO VALLEY, CA
94546-4055

Practice Phone: 510-886-3400
Practice Fax: 510-581-6517

Directions to “ DR. SIDNEY EVAN WANETICK MD” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.