MEDICARE: DR. WILLIAM G ANNAN MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	174400000X	Specialist	G13787	CA

General Provider Information

NPI Number	:	1124010384
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. WILLIAM G ANNAN MD

Provider Business Mailing Address
First Line	:	12555 GARDEN GROVE BLVD
Second Line	:	SUITE 302
City	:	GARDEN GROVE
State	:	CA
Zip	:	92843-1902
Country	:	US
Telephone Number	:	714-530-3270
Fax Number	:	714-530-3278

Provider Business Practice Location Address
First Line	:	12555 GARDEN GROVE BLVD
Second Line	:	SUITE 302
City	:	GARDEN GROVE
State	:	CA
Zip	:	92843-1902
Country	:	US
Telephone Number	:	714-530-3270
Fax Number	:	714-530-3278

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/15/2005
Last Update Date	:	07/08/2007

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