Dr WIDCHANUN PRASERTHDAM is a male medical professional, specializing in Cardiovascular Disease (cardiology). He graduated in 1999 from University Of South Florida College Of Medicine.
PERMANENTE MEDICAL GROUP INC
700 LAWRENCE EXPY
SANTA CLARA
CA
950515173
Tel: 4088511000
| Npi | 1457333478 |
| Pac Id | 9032399977 |
| Professional Enrollment Id | I20110209000425 |
| Last Name | PRASERTHDAM |
| First Name | WIDCHANUN |
| Middle Name | |
| Suffix | |
| Gender | M |
| Credential | |
| Medical School Name | UNIVERSITY OF SOUTH FLORIDA COLLEGE OF MEDICINE |
| Graduation Year | 1999 |
| Primary Specialty | CARDIOVASCULAR DISEASE (CARDIOLOGY) |
| Secondary Specialty 1 | INTERNAL MEDICINE |
| Secondary Specialty 2 | |
| Secondary Specialty 3 | |
| Secondary Specialty 4 | |
| All Secondary Specialties | INTERNAL MEDICINE |
| Organization Legal Name | PERMANENTE MEDICAL GROUP INC |
| Group Practice Pac Id | 8921910225 |
| Number Of Group Practice Members | 7392 |
| Line 1 Street Address | 700 LAWRENCE EXPY |
| Line 2 Street Address | |
| Marker Of Address Line 2 Suppression | |
| City | SANTA CLARA |
| State | CA |
| Zip Code | 950515173 |
| Phone Number | 4088511000 |
| Hospital Affiliation Ccn 1 | 050604 |
| Hospital Affiliation Lbn 1 | KAISER FOUNDATION HOSPITAL-SAN JOSE |
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| Professional Accepts Medicare Assignment | Y |
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