Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RP1001X | Pulmonary Disease | A155424 | CA |
NPI | 1013302215 |
---|---|
Provider Name | William Mckleroy |
First Address | San Francisco, CA 94143-2204 |
Second Address | San Francisco, CA 94143-2205 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 03/04/2015 |
Last Update Date | 22/12/2021 |