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Contact Information

DERRICK C WAN, MD
300 PASTEUR DR
PALO ALTO, CA94304-2203
 Phone: 650-723-4000
 Fax:
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Plastic Surgery

208200000X 02 Physician/General Surgery
 

Plastic and Reconstructive Surgery

2086S0122X 02 Physician/General Surgery
 

Undersea and Hyperbaric Medicine

2083P0011X 84 Physician/Preventive Medicine
Indicates primary specialty

NPI Profile & details for DERRICK C WAN · (Male)

NPI Number 1053513473
Status Active
Credentials MD
Entity Individual
Enumeration date 06/05/2007
Last updated 04/29/2024 - About 2 years ago
Sole proprietor 1 No
Identifiers
  • CA License # A83768
  • CA Medicaid 00A837680
Hospital affiliation(s)
  • STANFORD HOSPITAL - (Acute Care)
    300 PASTEUR DRIVE
    STANFORD, CA 94305
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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