MEDICARE: WILLIAM ANDREW ATKINS PT, OCS

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
1	225100000X	Physical Therapist	PT10446	CA
2	2251S0007X	Sports Physical Therapist	PT10446	CA
3	2251X0800X	Orthopedic Physical Therapist	PT10446	CA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	0342092	OTHER	CA	WA STATE DEPT OF LABOR AND INDUSTRIES

General Provider Information

NPI Number	:	1043294341
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	WILLIAM ANDREW ATKINS PT, OCS

Provider Business Mailing Address
First Line	:	29645 RANCHO CALIFORNIA RD
Second Line	:	STE. 234
City	:	TEMECULA
State	:	CA
Zip	:	92591-6200
Country	:	US
Telephone Number	:	951-506-3001
Fax Number	:	951-506-3002

Provider Business Practice Location Address
First Line	:	577 E ELDER ST
Second Line	:	SUITE I
City	:	FALLBROOK
State	:	CA
Zip	:	92028-3079
Country	:	US
Telephone Number	:	760-723-2687
Fax Number	:	760-723-2689

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	12/01/2005
Last Update Date	:	08/24/2015

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