Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RC0000X | Internist - Cardiovascular Disease | A23526 | CA |
NPI | 1013021708 |
---|---|
Provider Name | William Kenneth Halliday |
First Address | Cerritos, CA 90703-9329 |
Second Address | Montebello, CA 90640-2306 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 18/08/2006 |
Last Update Date | 29/08/2019 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
A23580 | (02) | CA |