Healthcare Provider Details

I. General information

NPI: 1720052988
Provider Name (Legal Business Name): WILLIAM WAYNE HOOPER MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/15/2006
Last Update Date: 10/09/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

320 SANTA FE DR SUITE 101
ENCINITAS CA
92024-5138
US

IV. Provider business mailing address

320 SANTA FE DR SUITE 101
ENCINITAS CA
92024-5138
US

V. Phone/Fax

Practice location:
  • Phone: 760-753-3424
  • Fax: 760-753-3425
Mailing address:
  • Phone: 760-753-3424
  • Fax: 760-753-3425

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RP1001X
TaxonomyPulmonary Disease Physician
License NumberG35446
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: