Healthcare Provider Details

I. General information

NPI: 1265499727
Provider Name (Legal Business Name): WILLIAM ANTHONY ORIGEL M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: X

II. Dates (important events)

Enumeration Date: 04/27/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2603 VIA CAMPO
MONTEBELLO CA
90640-1807
US

IV. Provider business mailing address

2603 VIA CAMPO
MONTEBELLO CA
90640-1807
US

V. Phone/Fax

Practice location:
  • Phone: 323-720-1144
  • Fax: 323-888-0637
Mailing address:
  • Phone: 323-720-1144
  • Fax: 323-888-0637

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License NumberG57128
License Number StateCA
# 2
Primary TaxonomyY
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License NumberG57128
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: