Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Jack Waxman, MD

Individual provider Rheumatology Physician · NPI 1104824994

Jack Waxman, MD is a Rheumatology Physician in Santa Rosa, California. Licensed in California. Registered with an NPI since 2005.

Licensed in
CA
In the registry since
2005
What do these letters mean?
MD — Doctor of Medicine
A physician who completed allopathic medical school.

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Practice location Address checks out

4015 Quartz Dr
Santa Rosa, CA 95405-5580
Phone: (707) 481-7215
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Rheumatology Physician (primary) Taxonomy 207RR0500X · Licence G23398 (CA)

Record details

NPI number1104824994
Entity typeIndividual (Type 1)
GenderMale
Credentials MD
Sole proprietorNo
NPI enumeratedJuly 14, 2005
Last updated in NPPESMarch 27, 2024
Certification dateMarch 27, 2024

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