Healthcare Provider Details

I. General information

NPI: 1952328478
Provider Name (Legal Business Name): WILLIAM THOMAS POIRIER MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/17/2006
Last Update Date: 11/04/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1600 SACRAMENTO INN WAY SUITE 116
SACRAMENTO CA
95815-3457
US

IV. Provider business mailing address

202 GOLD CIR
ROCKLIN CA
95765-4343
US

V. Phone/Fax

Practice location:
  • Phone: 916-564-5515
  • Fax: 916-564-5553
Mailing address:
  • Phone: 916-778-9421
  • Fax: 310-263-0100

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208D00000X
TaxonomyGeneral Practice Physician
License NumberG73756
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: