Healthcare Provider Details

I. General information

NPI: 1932205655
Provider Name (Legal Business Name): WILLIAM E OTTOWITZ III MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/16/2006
Last Update Date: 09/02/2026
Certification Date: 09/02/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

625 SOTO AVE
CORCORAN CA
93212-1653
US

IV. Provider business mailing address

1041 MARKET ST # 441
SAN DIEGO CA
92101-7233
US

V. Phone/Fax

Practice location:
  • Phone: 401-616-6815
  • Fax:
Mailing address:
  • Phone: 619-900-8349
  • Fax: 212-362-3546

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License NumberG84180
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: