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General NPI Number Information
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NPI Number | 1225145873
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Entity Type | Individual
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Provider Name | WILLIAM CHARLES FOWKES JR. M.D.
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Gender | Male
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Dates
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Enumeration Date | 08/23/2006
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Last Update Date | 02/15/2026
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Provider Practice Location Address
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Address Line | ROUTE 2, BOX 329
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City | LA HONDA
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State | CA
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Zip | 94020
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Country | US
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Telephone | 650-941-4684
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Fax |
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Provider Business Mailing Address
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Address Line | 22280 SKYLINE BLVD.
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City | LA HONDA
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State | CA
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Zip | 94020
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Country | US
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Telephone | 650-941-4684
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Fax | 650-941-4684
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207QG0300X
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Taxonomy Name | Geriatric Medicine (Family Medicine) Physician
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License Number | A17020
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License Number State | CA
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