Provider Demographics
NPI:1639117716
Name:RING, WENDY SUSAN (MD)
Entity Type:Individual
Prefix:
First Name:WENDY
Middle Name:SUSAN
Last Name:RING
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 2020
Mailing Address - Street 2:
Mailing Address - City:EUREKA
Mailing Address - State:CA
Mailing Address - Zip Code:95502-2020
Mailing Address - Country:US
Mailing Address - Phone:707-443-4666
Mailing Address - Fax:707-443-6123
Practice Address - Street 1:1522 THIRD ST
Practice Address - Street 2:
Practice Address - City:EUREKA
Practice Address - State:CA
Practice Address - Zip Code:95501-0711
Practice Address - Country:US
Practice Address - Phone:707-498-6183
Practice Address - Fax:707-443-6123
Is Sole Proprietor?:No
Enumeration Date:2006-06-02
Last Update Date:2008-09-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG53392207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CARHM03931GMedicaid
CAD4495Medicare UPIN
CARHM03931GMedicaid