Healthcare Provider Details

I. General information

NPI: 1376853655
Provider Name (Legal Business Name): WILLIAM ESSILFIE, M.D., INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/20/2010
Last Update Date: 10/20/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1141 W REDONDO BEACH BLVD SUITE 307
GARDENA CA
90247-3586
US

IV. Provider business mailing address

1141 W REDONDO BEACH BLVD SUITE 307
GARDENA CA
90247-3586
US

V. Phone/Fax

Practice location:
  • Phone: 310-715-6100
  • Fax: 310-715-6832
Mailing address:
  • Phone: 310-715-6100
  • Fax: 310-715-6832

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207RG0100X
TaxonomyGastroenterology Physician
License NumberA46137
License Number StateCA
# 2
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberA46137
License Number StateCA

VIII. Authorized Official

Name: DR. WILLIAM ESSILFIE
Title or Position: C.E.O.
Credential: M.D.
Phone: 310-715-6100