Healthcare Provider Details

I. General information

NPI: 1356088637
Provider Name (Legal Business Name): WILLIAM TRITCH
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/17/2022
Last Update Date: 08/19/2026
Certification Date: 08/19/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

28062 BAXTER RD
MURRIETA CA
92563-1401
US

IV. Provider business mailing address

11234 ANDERSON STREET GME OFFICE WESTERLY SUITE C
LOMA LINDA CA
92354-2804
US

V. Phone/Fax

Practice location:
  • Phone: 951-894-4665
  • Fax: 951-894-5178
Mailing address:
  • Phone: 909-558-4354
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberA190209
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: