Healthcare Provider Details

I. General information

NPI: 1285739532
Provider Name (Legal Business Name): WILLIAM G LITTMAN MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/13/2006
Last Update Date: 04/14/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

460 34TH ST
OAKLAND CA
94609
US

IV. Provider business mailing address

460 34TH ST
OAKLAND CA
94609
US

V. Phone/Fax

Practice location:
  • Phone: 510-652-8091
  • Fax: 510-652-5156
Mailing address:
  • Phone: 510-652-8091
  • Fax: 510-652-5156

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207N00000X
TaxonomyDermatology Physician
License NumberG31196
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code207ND0900X
TaxonomyDermatopathology Physician
License NumberG31196
License Number StateCA
# 3
Primary TaxonomyN
Taxonomy Code207NP0225X
TaxonomyPediatric Dermatology Physician
License NumberG31196
License Number StateCA
# 4
Primary TaxonomyN
Taxonomy Code207NS0135X
TaxonomyProcedural Dermatology Physician
License NumberG31196
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: