Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207Q00000X | Family Doctor | G41468 | CA |
N | 207QG0300X | Family Doctor - Geriatric Medicine | G41468 | CA |
NPI | 1285620666 |
---|---|
Provider Name | William S Warshal |
First Address | Saratoga, CA 95070-4421 |
Second Address | Saratoga, CA 95070-4421 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 21/09/2005 |
Last Update Date | 20/10/2015 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
00G414681 | (05) | CA |
A48580 | (02) |