Provider Demographics
NPI:1033228739
Name:WARMERDAM, DOROTHEEA OANA (MD)
Entity Type:Individual
Prefix:DR
First Name:DOROTHEEA
Middle Name:OANA
Last Name:WARMERDAM
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:1700 ALHAMBRA BLVD
Mailing Address - Street 2:STE 202
Mailing Address - City:SACRAMENTO
Mailing Address - State:CA
Mailing Address - Zip Code:95816
Mailing Address - Country:US
Mailing Address - Phone:916-731-8040
Mailing Address - Fax:916-454-4152
Practice Address - Street 1:1830 SIERRA GARDENS DR
Practice Address - Street 2:STE 100
Practice Address - City:ROSEVILLE
Practice Address - State:CA
Practice Address - Zip Code:95661-2942
Practice Address - Country:US
Practice Address - Phone:916-786-6966
Practice Address - Fax:916-677-0261
Is Sole Proprietor?:No
Enumeration Date:2006-08-29
Last Update Date:2012-11-05
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CAA96243207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAGR0042242Medicaid
CAGR0042242Medicaid