DR. JESSE JULIAN WAGGONER (NPI# 1003081357) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1003081357 |
| Entity Type | Individual |
| Full Name | DR. JESSE JULIAN WAGGONER |
| Credential | M.D. |
| Practice Address |
1301 Shoreway Rd Suite 100 Belmont CA 94002-4151 |
| Practice Telephone | 6505967000 |
| Practice Fax Number | 6505967096 |
| Mailing Telephone | 6505967000 |
| Mailing Fax Number | 6505967096 |
| Enumeration Date | 2008-04-28 |
| Last Update Date | 2014-06-16 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 207R00000X | Internal Medicine | A110151 | CA | Allopathic & Osteopathic Physicians |
| Y | 207RI0200X |
Internal Medicine Specialization: Infectious Disease |
A110151 | CA | Allopathic & Osteopathic Physicians |
| Street Address |
1301 SHOREWAY RD SUITE 100 |
| City | BELMONT |
| State | CA |
| Zip Code | 94002-4151 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1720009673 | Elizabeth Kocot | Internal Medicine | 1301 Shoreway Rd, Suite 100, Belmont, CA 94002-4151 | 2006-07-23 |
| 1801196605 | Gulpana M Mohammad | Family Medicine | 1301 Shoreway Rd, Suite 100, Belmont, CA 94002 | 2010-10-26 |
| 1740429182 | Chw Medical Foundation | Clinic/Center | 1301 Shoreway Rd, Suite 100, Belmont, CA 94002-4151 | 2009-02-09 |
| 1336315241 | Elizabeth Soda | Internal Medicine | 1301 Shoreway Rd, Suite 100, Belmont, CA 94002-4151 | 2008-05-01 |
| 1215108204 | Select Physical Therapy Holdings Inc | Durable Medical Equipment & Medical Supplies | 1301 Shoreway Rd, Number 280, Belmont, CA 94002-4151 | 2008-03-18 |
| 1568668234 | Lynda Ann Mackin | Nurse Practitioner | 1301 Shoreway Rd, Suite 100, Belmont, CA 94002-4151 | 2007-06-21 |
| 1780772376 | Adil K Jadallah | Family Medicine | 1301 Shoreway Rd, Suite 100, Belmont, CA 94002-4151 | 2006-10-10 |
| 1962502872 | Randolph A. Chen | Internal Medicine | 1301 Shoreway Rd, Suite 100, Belmont, CA 94002-4151 | 2006-09-22 |
| 1518970409 | Gary A Greensweig | Family Medicine | 1301 Shoreway Rd, Ste. 100, Belmont, CA 94002-4151 | 2006-08-14 |
| 1174531859 | Dignity Health Medical Foundation | Clinic/Center | 1301 Shoreway Rd, Suite 100, Belmont, CA 94002-4151 | 2006-08-04 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1740728740 | Simon Hirschl | Pathology | 9 Kittie Lane, Belmont, CA 94002 | 2017-02-09 |
| 1902251028 | Emma Yan Hiu Lee Chou | Occupational Therapist | 2410 Carlmont Dr, Belmont, CA 94002 | 2016-04-26 |
| 1740578087 | The Latino Commisson | Substance Abuse Rehabilitation Facility | 401 Briarfield Way, Belmont, CA 94002 | 2011-07-20 |
| 1053624189 | Pragya Jain | Internal Medicine | 1301 Shoreway Rd., Ste. 100, Belmont, CA 94002 | 2010-07-18 |
| 1194956425 | Lilia Patricia Gallegos | Marriage & Family Therapist | 1 Davis Drive, Belmont, CA 94002 | 2009-08-04 |
| 1407099088 | Dharmesh Patel | Radiology | 513 Seagate Way, Belmont, CA 94002 | 2009-04-13 |
| 1376688044 | Paul M. Takla | Dentist | 2130 Ralston Ave, Suite 1e, Belmont, CA 94002 | 2007-02-21 |
| 1487799987 | Mark Joseph Mcmahon | Physical Therapist | 549 Ralson Avenue, Suite B, Belmont, CA 94002 | 2007-02-21 |
| 1639216112 | Patricia Mary Wieser | Nurse Practitioner | 1541 Harbor Blvd, Belmont, CA 94002 | 2007-01-31 |
| 1063575157 | Peninsula Specialty Care | Dentist | 562 Ralston Ave, Belmont, CA 94002 | 2006-12-19 |
| Find all providers in zip 94002 | ||||
| Taxonomy Code | 207RI0200X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Internal Medicine |
| Specialization | Infectious Disease |
| An internist who deals with infectious diseases of all types and in all organ systems. Conditions requiring selective use of antibiotics call for this special skill. This physician often diagnoses and treats AIDS patients and patients with fevers which have not been explained. Infectious disease specialists may also have expertise in preventive medicine and travel medicine. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source; 7/1/2011: modified source] - Additional Resources: American Board of Internal Medicine, 2007. http://www.abim.org/. American Osteopathic Board of Internal Medicine, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Internal Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Internal Medicine. |
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| 1295182335 | East Bay Area Quality Health Corporation | Internal Medicine | 400 29th Ave, Suite 501, Oakland, CA 94601-2106 | 2016-05-18 |
| 1174985451 | Nicholas Robert Degner | Internal Medicine | 705 San Carlo Ave, Colton, CA 92324-6864 | 2016-03-24 |
| 1184084865 | Mohammad Yousef Alkhatib Md Inc | Internal Medicine | 79405 Highway 111 Ste 9-334, La Quinta, CA 92253-8300 | 2016-02-24 |
| 1710345095 | Pacific Beach Medical Group, Inc. | Internal Medicine | 16111 Beach Blvd., Huntington Beach, CA 92647 | 2016-02-02 |
| 1407239700 | Alan Koff | Internal Medicine | 4860 Y St Ste 0101, Sacramento, CA 95817-2307 | 2015-07-04 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.