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General NPI Number Information
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NPI Number | 1053590984
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Entity Type | Organization
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Legal Business Name | CARRAGHER OSTEOPATHIC INC.
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Dates
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Enumeration Date | 10/27/2007
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Last Update Date | 01/07/2009
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Provider Practice Location Address
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Address Line | 7235 SANTA MONICA BLVD
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City | WEST HOLLYWOOD
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State | CA
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Zip | 90046-6724
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Country | US
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Telephone | 323-874-9355
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Fax | 323-874-9357
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Provider Business Mailing Address
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Address Line | 7235 SANTA MONICA BLVD
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City | WEST HOLLYWOOD
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State | CA
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Zip | 90046-6724
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Country | US
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Telephone | 323-874-9355
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Fax | 323-874-9357
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Authorized Official
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Title or Position | PRESIDENT/OWNER
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Name | DR. WILLIAM M CARRAGHER III
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Credential | M.D.
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Telephone | 323-874-9355
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 20A7692
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | 20A7692
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License Number State | CA
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Taxonomy #3
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Taxonomy Code | 208100000X
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Taxonomy Name | Physical Medicine & Rehabilitation Physician
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License Number | 20A7692
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License Number State | CA
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Taxonomy #4
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Taxonomy Code | 208D00000X
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Taxonomy Name | General Practice Physician
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License Number | 20A7692
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License Number State | CA
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