Derrick C Wan (NPI# 1053513473, PAC ID# 3375697931) is a physician enrolled in Centers for Medicare & Medicaid Services (CMS). The primary specialty is PLASTIC AND RECONSTRUCTIVE SURGERY.
| Nation Provider ID (NPI) | 1053513473 |
| PAC ID by PECOS | 3375697931 |
| Professional Enrollment ID | I20090817000143 |
| Full Name | Derrick C Wan |
| Organization Legal Name | LPCH MEDICAL GROUP DIV OF LUCILE |
| Address |
725 Welch Rd Palo Alto CA 94304-1601 |
| Phone Number | 6504987200 |
| Gender | M |
| Medical School | COLUMBIA UNIVERSITY COLLEGE OF PHYSICIANS AND SURGEONS |
| Graduation Year | 2001 |
| Primary Specialty | PLASTIC AND RECONSTRUCTIVE SURGERY |
| Group Practice PAC ID | 0840298543 |
| Number of Group Practice Members | 212 |
| Accepts Medicare Assignment | Y |
| Claim Control Number (CCN) | Legal Business Name |
|---|---|
| 050441 | STANFORD HEALTH CARE |
| Address | Phone | Organization |
|---|---|---|
| 725 Welch Rd, Palo Alto, CA 94304-1601 | 6504987200 | LPCH MEDICAL GROUP DIV OF LUCILE |
| 420 Broadway St, Redwood City, CA 94063-3132 | 6507238561 | STANFORD HEALTH CARE |
| 450 Broadway St, Redwood City, CA 94063-3132 | 6507238561 | STANFORD HEALTH CARE |
| 300 Pasteur Dr, Stanford, CA 94305-2200 | 6507234000 | STANFORD HEALTH CARE |
| Organization Legal Name | LPCH MEDICAL GROUP DIV OF LUCILE |
| Physicians | 404 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Asheen Rama | Anesthesiology | Lpch Medical Group Div of Lucile | 725 Welch Rd, Palo Alto, CA 94304-1601 |
| Peter Andrew Meaney | Pediatric Medicine | Lpch Medical Group Div of Lucile | 725 Welch Rd, Palo Alto, CA 94304-1601 |
| Stafford Robert Grady Jr. | Cardiovascular Disease (cardiology) | Lpch Medical Group Div of Lucile | 725 Welch Rd, Palo Alto, CA 94304-1601 |
| Sharon Chen | Pediatric Medicine | Lpch Medical Group Div of Lucile | 725 Welch Rd, Palo Alto, CA 94304-1601 |
| Mary B Leonard | Nephrology | Lpch Medical Group Div of Lucile | 725 Welch Rd, Palo Alto, CA 94304-1601 |
| Andy Yen-ming Wen | Pediatric Medicine | Lpch Medical Group Div of Lucile | 725 Welch Rd, Palo Alto, CA 94304-1601 |
| Heather Marshall Byers | Pediatric Medicine | Lpch Medical Group Div of Lucile | 725 Welch Rd, Palo Alto, CA 94304-1601 |
| Rajni Agarwal | Pediatric Medicine | Lpch Medical Group Div of Lucile | 725 Welch Rd, Palo Alto, CA 94304-1601 |
| Janani Venugopalakrishnan | Psychiatry | Lpch Medical Group Div of Lucile | 725 Welch Rd, Palo Alto, CA 94304-1601 |
| Jennifer Anne Moon | Nurse Practitioner | Lpch Medical Group Div of Lucile | 725 Welch Rd, Palo Alto, CA 94304-1601 |
| Street Address |
725 WELCH RD |
| City | PALO ALTO |
| State | CA |
| Zip | 94304-1601 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Asheen Rama | Anesthesiology | Lpch Medical Group Div of Lucile | 725 Welch Rd, Palo Alto, CA 94304-1601 |
| Peter Andrew Meaney | Pediatric Medicine | Lpch Medical Group Div of Lucile | 725 Welch Rd, Palo Alto, CA 94304-1601 |
| Stafford Robert Grady Jr. | Cardiovascular Disease (cardiology) | Lpch Medical Group Div of Lucile | 725 Welch Rd, Palo Alto, CA 94304-1601 |
| Sharon Chen | Pediatric Medicine | Lpch Medical Group Div of Lucile | 725 Welch Rd, Palo Alto, CA 94304-1601 |
| Mary B Leonard | Nephrology | Lpch Medical Group Div of Lucile | 725 Welch Rd, Palo Alto, CA 94304-1601 |
| Andy Yen-ming Wen | Pediatric Medicine | Lpch Medical Group Div of Lucile | 725 Welch Rd, Palo Alto, CA 94304-1601 |
| Heather Marshall Byers | Pediatric Medicine | Lpch Medical Group Div of Lucile | 725 Welch Rd, Palo Alto, CA 94304-1601 |
| Rajni Agarwal | Pediatric Medicine | Lpch Medical Group Div of Lucile | 725 Welch Rd, Palo Alto, CA 94304-1601 |
| Janani Venugopalakrishnan | Psychiatry | Lpch Medical Group Div of Lucile | 725 Welch Rd, Palo Alto, CA 94304-1601 |
| Jennifer Anne Moon | Nurse Practitioner | Lpch Medical Group Div of Lucile | 725 Welch Rd, Palo Alto, CA 94304-1601 |
| Find all physicians in the same address | |||
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Hailen Mak | Allergy/immunology | Welch Pasteur Allergy Medical Group Inc | 211 Quarry Rd, Suite 106, Palo Alto, CA 94304-1416 |
| Maren L Pedersen | Internal Medicine | 211 Quarry Rd, Suite 203, Palo Alto, CA 94304-1416 | |
| Anita C Choy | Allergy/immunology | Welch Pasteur Allergy Medical Group Inc | 211 Quarry Rd, Suite 106, Palo Alto, CA 94304-1416 |
| Francis H Koch | Cardiovascular Disease (cardiology) | 211 Quarry Rd, Suite 203, Palo Alto, CA 94304-1416 | |
| Irene Shih | Internal Medicine | 211 Quarry Rd, Suite 203, Palo Alto, CA 94304-1416 | |
| Andrew B Newman | Pulmonary Disease | 750 Welch Rd, Suite 104, Palo Alto, CA 94304-1508 | |
| Yusra N Hussain | Internal Medicine | 770 Welch Rd, Suite 250, Palo Alto, CA 94304-1513 | |
| David S Shields | Gastroenterology | 770 Welch Rd, Suite 250, Palo Alto, CA 94304-1513 | |
| Jack H Koumjian | Oral Surgery | 770 Welch Rd, Suite 280, Palo Alto, CA 94304-1513 | |
| Jonathan Tiago Avila | Pediatric Medicine | Lpch Medical Group Div of Lucile | 725 Welch Rd, Palo Alto, CA 94304-1601 |
| Find all physicians in zip 94304 | |||
| City | PALO ALTO |
| Zip Code | 94304 |
| Specialty | PLASTIC AND RECONSTRUCTIVE SURGERY |
| City + Specialty | PALO ALTO + PLASTIC AND RECONSTRUCTIVE SURGERY |
Please comment or provide details below to improve the information on Derrick C Wan.
| Data Provider | Centers for Medicare & Medicaid Services (CMS) |
| Jurisdiction | Medicare |
This dataset includes 1.12 million groups, individual physicians, and other clinicians currently enrolled in Medicare. Each physician is registered with NPI, PAC ID, full name, specialty, phone, organization, hospital, address, medical school, etc.