Provider Demographics
NPI:1043316748
Name:RELEFORD, BILL J (DPM)
Entity Type:Individual
Prefix:
First Name:BILL
Middle Name:J
Last Name:RELEFORD
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:333 E NUTWOOD ST
Mailing Address - Street 2:
Mailing Address - City:INGLEWOOD
Mailing Address - State:CA
Mailing Address - Zip Code:90301-2354
Mailing Address - Country:US
Mailing Address - Phone:310-412-0183
Mailing Address - Fax:310-412-0171
Practice Address - Street 1:333 E NUTWOOD ST
Practice Address - Street 2:
Practice Address - City:INGLEWOOD
Practice Address - State:CA
Practice Address - Zip Code:90301-2354
Practice Address - Country:US
Practice Address - Phone:310-412-0183
Practice Address - Fax:310-412-0171
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-16
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAE3630213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAE3630Medicare ID - Type Unspecified
CA000E36300Medicare UPIN