Healthcare Provider Details

I. General information

NPI: 1083731673
Provider Name (Legal Business Name): WILLIAM CIPRIANO M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/26/2007
Last Update Date: 01/05/2022
Certification Date: 01/05/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5743 CORSA AVE STE #117
WESTLAKE VLG CA
91362-6459
US

IV. Provider business mailing address

5743 CORSA AVE STE 117
WESTLAKE VLG CA
91362-6459
US

V. Phone/Fax

Practice location:
  • Phone: 818-707-9440
  • Fax: 818-707-7627
Mailing address:
  • Phone: 818-707-9440
  • Fax: 818-707-7627

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2084P0804X
TaxonomyChild & Adolescent Psychiatry Physician
License NumberG62343
License Number StateCA
# 2
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License NumberG62343
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: