Healthcare Provider Details

I. General information

NPI: 1972280824
Provider Name (Legal Business Name): WILLIAM ROD SAEZ FNP
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/03/2023
Last Update Date: 07/03/2023
Certification Date: 07/02/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4867 W SUNSET BLVD
LOS ANGELES CA
90027-5969
US

IV. Provider business mailing address

207 S TOPO ST
ANAHEIM CA
92804-2217
US

V. Phone/Fax

Practice location:
  • Phone: 323-783-9731
  • Fax:
Mailing address:
  • Phone: 213-210-1181
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number95025576
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: