Provider Demographics
NPI:1154309862
Name:RESH, WILLIAM FRANK (MD)
Entity Type:Individual
Prefix:MR
First Name:WILLIAM
Middle Name:FRANK
Last Name:RESH
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:292 AVOCADO AVE
Mailing Address - Street 2:
Mailing Address - City:EL CAJON
Mailing Address - State:CA
Mailing Address - Zip Code:92020-4604
Mailing Address - Country:US
Mailing Address - Phone:619-579-5115
Mailing Address - Fax:619-749-6174
Practice Address - Street 1:292 AVOCADO AVE
Practice Address - Street 2:
Practice Address - City:EL CAJON
Practice Address - State:CA
Practice Address - Zip Code:92020-4604
Practice Address - Country:US
Practice Address - Phone:619-579-5115
Practice Address - Fax:619-749-6174
Is Sole Proprietor?:No
Enumeration Date:2006-01-03
Last Update Date:2018-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAC34661207N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00C346610Medicaid
A35693Medicare UPIN
CAWC34661AMedicare ID - Type Unspecified