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NPI Code Detail

MEDICARE: DR. WILLIAM J. WATSON M.D.

MEDICARE: DR. WILLIAM J. WATSON M.D.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207Y00000XOtolaryngology PhysicianG42368CA

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
14036521OTHERCAAETNA PIN
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3ZZZ25994ZOTHERCABLUE SHIELD PIN

General Provider Information

NPI Number : 1023007507
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. WILLIAM J. WATSON M.D.
Provider Business Mailing Address
First Line : 1035 PEACH ST
Second Line : SUITE 301
City : SAN LUIS OBISPO
State : CA
Zip : 93401-2700
Country : US
Telephone Number : 805-545-5665
Fax Number : 805-544-6477
Provider Business Practice Location Address
First Line : 1035 PEACH ST
Second Line : SUITE 301
City : SAN LUIS OBISPO
State : CA
Zip : 93401-2700
Country : US
Telephone Number : 805-545-5665
Fax Number : 805-544-6477
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/18/2005
Last Update Date : 11/28/2007

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