Provider Demographics
NPI:1053566554
Name:DON H WASSERMAN MD LTD
Entity type:Organization
Organization Name:DON H WASSERMAN MD LTD
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:DON
Authorized Official - Middle Name:H
Authorized Official - Last Name:WASSERMAN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:530-751-4730
Mailing Address - Street 1:370 DEL NORTE AVE
Mailing Address - Street 2:STE 204
Mailing Address - City:YUBA CITY
Mailing Address - State:CA
Mailing Address - Zip Code:95991
Mailing Address - Country:US
Mailing Address - Phone:530-751-4730
Mailing Address - Fax:530-751-4793
Practice Address - Street 1:370 DEL NORTE AVE
Practice Address - Street 2:STE 204
Practice Address - City:YUBA CITY
Practice Address - State:CA
Practice Address - Zip Code:95991-4142
Practice Address - Country:US
Practice Address - Phone:530-751-4730
Practice Address - Fax:530-751-4793
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-11-25
Last Update Date:2008-11-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG10754208800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208800000XAllopathic & Osteopathic PhysiciansUrologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAZZZ27738ZMedicare PIN