Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207Y00000X | Otolaryngologist (ENT Doctor) | C33164 | CA |
NPI | 1003965039 |
---|---|
Provider Name | Dr. William John Owsley |
First Address | Newport Beach, CA 92660-5599 |
Second Address | Newport Beach, CA 92660-5599 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 09/01/2007 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
A35188 | (02) | CA |