Provider Demographics
NPI:1578528170
Name:WACHTER, ROBERT M (MD)
Entity Type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:M
Last Name:WACHTER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:505 PARNASSUS AVE
Mailing Address - Street 2:M-994
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94143-0001
Mailing Address - Country:US
Mailing Address - Phone:415-476-7991
Mailing Address - Fax:415-502-5869
Practice Address - Street 1:505 PARNASSUS AVE
Practice Address - Street 2:M-994
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94143-0001
Practice Address - Country:US
Practice Address - Phone:415-476-7991
Practice Address - Fax:415-502-5869
Is Sole Proprietor?:No
Enumeration Date:2006-04-18
Last Update Date:2022-02-24
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CAG53933207R00000X, 208M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208M00000XAllopathic & Osteopathic PhysiciansHospitalist
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA0G5393300Medicaid
CA0G5393300Medicaid
CA0G5393300Medicare PIN