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General NPI Number Information
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NPI Number | 1699011221
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Entity Type | Individual
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Provider Name | WILLIAM WARREN GILLESPIE D.C.
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Gender | Male
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Dates
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Enumeration Date | 12/31/2012
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Last Update Date | 12/31/2012
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Provider Practice Location Address
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Address Line | 9385 OLD STATE HWY
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City | NEWCASTLE
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State | CA
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Zip | 95658-9597
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Country | US
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Telephone | 916-672-8470
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 681
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City | NEWCASTLE
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State | CA
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Zip | 95658-0681
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Country | US
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Telephone | 916-791-0522
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Fax |
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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 | 111N00000X
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Taxonomy Name | Chiropractor
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License Number | 25871
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License Number State | CA
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