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NPI Code Detail

MEDICARE: MR. WILLIAM TAWHEED HAYNES PEER SPECIALIST

MEDICARE:  MR. WILLIAM TAWHEED HAYNES  PEER SPECIALIST
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
1175T00000XPeer SpecialistMPSS-EHKLBZCA

General Provider Information

NPI Number : 1386998722
Entity Type Code : Individual
Provider Name (Legal Business Name) : MR. WILLIAM TAWHEED HAYNES PEER SPECIALIST
Provider Business Mailing Address
First Line : 3125 MYERS ST
Second Line :
City : RIVERSIDE
State : CA
Zip : 92503-5527
Country : US
Telephone Number : 951-358-3725
Fax Number : 951-358-3725
Provider Business Practice Location Address
First Line : 2085 RUSTIN AVE
Second Line :
City : RIVERSIDE
State : CA
Zip : 92507-2498
Country : US
Telephone Number : 951-955-9375
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/07/2012
Last Update Date : 04/17/2026

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Directions to “ MR. WILLIAM TAWHEED HAYNES PEER SPECIALIST” Practice Location

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