Provider Demographics
NPI:1265671341
Name:WILLIAM W, FOOTE, MD PROFESSIONAL CORPORATION
Entity Type:Organization
Organization Name:WILLIAM W, FOOTE, MD PROFESSIONAL CORPORATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:WILLIAM
Authorized Official - Middle Name:WORTH
Authorized Official - Last Name:FOOTE
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:415-567-5684
Mailing Address - Street 1:1819 UNION ST
Mailing Address - Street 2:
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94123-4307
Mailing Address - Country:US
Mailing Address - Phone:415-567-5684
Mailing Address - Fax:415-346-0931
Practice Address - Street 1:1819 UNION ST
Practice Address - Street 2:
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94123-4307
Practice Address - Country:US
Practice Address - Phone:415-567-5684
Practice Address - Fax:415-346-0931
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-02-12
Last Update Date:2009-02-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA2084P0800XOtherPROVIDER TAXONOMIES
CA00A212520Medicare PIN
CA2084P0800XOtherPROVIDER TAXONOMIES