Healthcare Provider Details

I. General information

NPI: 1407043847
Provider Name (Legal Business Name): WILLIAM J ACKERMAN MD APC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/01/2007
Last Update Date: 07/09/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

320 SANTA FE DR STE 308
ENCINITAS CA
92024-5138
US

IV. Provider business mailing address

320 SANTE FE DR 308
ENCINITAS CA
92024-5139
US

V. Phone/Fax

Practice location:
  • Phone: 760-944-0223
  • Fax:
Mailing address:
  • Phone: 760-944-0223
  • Fax: 760-436-8739

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RP1001X
TaxonomyPulmonary Disease Physician
License NumberG27312
License Number StateCA

VIII. Authorized Official

Name: DR. WILLIAM JOSEPH ACKERMAN
Title or Position: CEO
Credential: MD
Phone: 760-944-0223