Provider Demographics
NPI:1043294341
Name:ATKINS, WILLIAM ANDREW (PT, OCS)
Entity type:Individual
Prefix:
First Name:WILLIAM
Middle Name:ANDREW
Last Name:ATKINS
Suffix:
Gender:M
Credentials:PT, OCS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:29645 RANCHO CALIFORNIA RD
Mailing Address - Street 2:STE. 234
Mailing Address - City:TEMECULA
Mailing Address - State:CA
Mailing Address - Zip Code:92591-6200
Mailing Address - Country:US
Mailing Address - Phone:951-506-3001
Mailing Address - Fax:951-506-3002
Practice Address - Street 1:577 E ELDER ST
Practice Address - Street 2:SUITE I
Practice Address - City:FALLBROOK
Practice Address - State:CA
Practice Address - Zip Code:92028-3079
Practice Address - Country:US
Practice Address - Phone:760-723-2687
Practice Address - Fax:760-723-2689
Is Sole Proprietor?:No
Enumeration Date:2005-12-01
Last Update Date:2015-08-24
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CAPT10446225100000X, 2251S0007X, 2251X0800X
CA2251S0007X, 2251X0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251X0800XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistOrthopedic
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
No2251S0007XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistSports
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA0342092OtherWA STATE DEPT OF LABOR AND INDUSTRIES
CA0342092OtherWA STATE DEPT OF LABOR AND INDUSTRIES
CAHM922ZMedicare PIN
CAHM922ZMedicare PIN