SHANE RICHARD WURDEMAN


Address: 11301 Wilshire Blvd, Bldg 304, Los Angeles, CA 90073-1003
Phone: 3104783711

SHANE RICHARD WURDEMAN (NPI# 1497911572) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1497911572
Entity Type Individual
Full Name SHANE RICHARD WURDEMAN
Credential CP
Practice Address 11301 Wilshire Blvd
Bldg 304
Los Angeles
CA 90073-1003
Mailing Address 1323 14th St
Apt. E
Santa Monica
CA 90404-1744
Practice Telephone 3104783711
Mailing Telephone 3104783711
Enumeration Date 2008-07-29
Last Update Date 2008-07-29
Gender Code M
Is Sole Proprietor N

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 224P00000X Prosthetist CP003610 CA Respiratory, Developmental, Rehabilitative and Restorative Service Providers

Office Location

Street Address 11301 WILSHIRE BLVD
BLDG 304
City LOS ANGELES
State CA
Zip Code 90073-1003

Providers in the same location

NPI Name Taxonomy Address Enumeration
1295739043 Mark S Horng Internal Medicine 11301 Wilshire Blvd, 10-c-1, Los Angeles, CA 90073-1003 2005-06-09
1720685944 Sara Magdalin Dietitian, Registered 11301 Wilshire Blvd, Los Angeles, CA 90073-1003 2020-10-01
1336750223 Nathalie Esther Halajian Student in an Organized Health Care Education/Training Program 11301 Wilshire Blvd, Los Angeles, CA 90073-1003 2020-08-13
1811508344 Hillary Xanthe Enclade Speech-Language Pathologist 11301 Wilshire Blvd, Los Angeles, CA 90073-1003 2020-08-10
1356950919 Maren Abromowitz Registered Nurse 11301 Wilshire Blvd, Los Angeles, CA 90073-1003 2020-07-29
1285243030 Alyson Prince Shittu Registered Nurse 11301 Wilshire Blvd, Los Angeles, CA 90073-1003 2020-07-28
1124637087 Soheil Kooraki Student in an Organized Health Care Education/Training Program 11301 Wilshire Blvd, Los Angeles, CA 90073-1003 2020-07-27
1376152371 Ynez Sabio Registered Nurse 11301 Wilshire Blvd, Los Angeles, CA 90073-1003 2020-07-24
1154949972 Leah Effron Registered Nurse 11301 Wilshire Blvd, Los Angeles, CA 90073-1003 2020-07-08
1972120988 Justin Man Truong Pharmacist 11301 Wilshire Blvd, Los Angeles, CA 90073-1003 2020-06-25
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Providers in the same zip code

NPI Name Taxonomy Address Enumeration
1184223851 Emily Jenchura Psychologist 11301 Wilshire Blvd (116b, Rm. A-130), Los Angeles, CA 90073 2020-10-22
1184285090 Marcela Leticia Orellana Galvez Podiatrist 11301 Wilshire Blvd Bldg 500, Dept of Surgery, #10-h-2, Los Angeles, CA 90073 2019-06-23
1508310996 Jennifer Maravola Student in an Organized Health Care Education/Training Program 11303 Wilshire Bl. Bdg 116, New Direction Inc., Los Angeles, CA 90073 2016-08-15
1861859480 Michael Fisher Student in an Organized Health Care Education/Training Program 11303 Willshire Blv., V.a. Building 116, Los Angeles, CA 90073 2016-01-27
1629453295 Christopher Denzel Lewis Student in an Organized Health Care Education/Training Program 11303 Wilshire Blvd., Va Bldg. 116, Los Angeles, CA 90073 2015-07-24
1689089179 Rachel Stannus Social Worker 11303 Wilshire Blvd, Bldg116, Los Angeles, CA 90073 2014-06-24
1215355433 Michael Francis Zito Psychiatry & Neurology 11301 Wilshire Blvd Bldg 210a, Los Angeles, CA 90073 2014-04-03
1831523901 Sarah Arensman Miller Psychologist 11301 Wilshire Blvd. Bldg 256, Rm 106a, Va West Los Angeles (116b), Los Angeles, CA 90073 2013-08-26
1134447733 Stuart Thomas Yee Physical Medicine & Rehabilitation 11301 Wilshire Blvd. Mail Code 117, Los Angeles, CA 90073 2010-05-07
1306177654 Pete Petriashvili Student in an Organized Health Care Education/Training Program 11301 Wilshire Blvd, Building 500, Room 4455, Los Angeles, CA 90073 2010-01-27
Find all providers in zip 90073

Taxonomy Information

Taxonomy Code 224P00000X
Grouping Respiratory, Developmental, Rehabilitative and Restorative Service Providers
Classification Prosthetist

Taxonomy Definition

A health care professional who is specifically educated and trained to manage comprehensive prosthetic patient care for individuals who have sustained complete or partial limb loss or absence. Prosthetists assess specific patient needs, formulate an appropriate treatment plan, implement the treatment plan and provide follow-up care.
Notes: Source: American Board for Certification in Orthotics, Prosthetics, and Pedorthics, Inc. [7/1/2010: modified, 7/1/2013: modified] Additional Resources: American Board for Certification in Orthotics, Prosthetics and Pedorthics, Inc., www.abcop.org and Board of Certification/Accreditation, International, www.bocusa.org.

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
1831733948 Shayla R Williams Prosthetist 11050 Strathmore Dr Apt 422, Los Angeles, CA 90024-2319 2019-10-31
1255815155 Mary Alice Swiney Prosthetist 3437 Stocker St Apt 4, Los Angeles, CA 90008-3730 2018-09-18
1114013158 Los Angeles Institute for Prosthetics and Orthotics Inc Prosthetist 443 1/2 So Atlantic Blvd, Los Angeles, CA 90022-2617 2006-10-05
1033736848 Sue Sean Prosthetist 1830 W Olympic Blvd Ste 123, Los Angeles, CA 90006-3734 2020-06-26
1770082570 Matthew Mills Prosthetist 6300 Wilshire Blvd, Los Angeles, CA 90048-5204 2018-02-07
1841744034 David Craft Prosthetist 3160 Geneva St, Los Angeles, CA 90020-1117 2016-08-05
1316134802 Suzanne Mary Eckhardt Prosthetist 637 Lucas Ave, Los Angeles, CA 90017-1912 2007-09-27

Providers in the same taxonomy and state

NPI Name Taxonomy Address Enumeration
1134752942 Elizabeth Olajide Prosthetist 43536 Gadsden Ave Apt 324, Lancaster, CA 93534-6036 2020-02-20
1578111290 Charmie Johnson Prosthetist 7309 University Ave Ste B, La Mesa, CA 91942-0525 2019-08-27
1790341915 Gloria Tatiana Dixon Prosthetist 32366 Evening Primrose Trl, Campo, CA 91906-3162 2019-05-13
1629633219 Duana Robinson Prosthetist 1430 Brandon Dewey Ln, Tracy, CA 95304-5981 2019-05-08
1366908741 Alicia Lander Prosthetist 5252 Foothill Blvd, Oakland, CA 94601-5438 2019-02-11
1154895944 Keyonia K Paramore Prosthetist 735 W Pacific Coast Hwy, Long Beach, CA 90806-5240 2019-01-15
1629544499 Alexander Hetherington Prosthetist 1500 Owens St Ste 115, San Francisco, CA 94158-2338 2018-10-19
1285113951 Janet Miller Prosthetist 6662 Charlene Ave, San Diego, CA 92114 2018-08-13
1710482807 John Vetter Prosthetist 5110 Whitsett Ave, Valley Village, CA 91607-3016 2018-03-29
1144728569 Shiaw Wen Wu Prosthetist 1009 N Orange Ave, Azusa, CA 91702-1920 2018-01-31
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Competitor

Search similar providers

City LOS ANGELES
Zip Code 90073

Improve Information

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Dataset Information

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.

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