Waneka, Stacy L

Waneka, Stacy L is an sole proprietor health care provider with primary practice located at 881 Alma Real Dr Ste 316, Pacific Palisades CA 90272. She recently has only one registered license in Allopathic & Osteopathic Physicians / Family Medicine, which is considered as her primary health care specialty. Waneka, Stacy L can be contacted via phone (310) 454-1317.

Contact Information

Primary practice address
881 Alma Real Dr Ste 316 Pacific Palisades CA 90272
Phone: (310) 454-1317
Fax: (310) 454-1709
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X A68263 California

Profile Details

NPI number 1871557546
LBN Legal business name Waneka, Stacy L
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Apr 12th, 2006
Last updated Jul 3rd, 2013 - about 11 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1871557546 NPPES
California Other 203165086 TAX ID

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