Provider Demographics
NPI:1346254745
Name:PRITCHARD, WILLIAM MICHAEL (OD)
Entity Type:Individual
Prefix:
First Name:WILLIAM
Middle Name:MICHAEL
Last Name:PRITCHARD
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2020 HUNTINGTON DR
Mailing Address - Street 2:
Mailing Address - City:SAN MARINO
Mailing Address - State:CA
Mailing Address - Zip Code:91108-2022
Mailing Address - Country:US
Mailing Address - Phone:626-289-7856
Mailing Address - Fax:626-284-6532
Practice Address - Street 1:2020 HUNTINGTON DR
Practice Address - Street 2:
Practice Address - City:SAN MARINO
Practice Address - State:CA
Practice Address - Zip Code:91108-2022
Practice Address - Country:US
Practice Address - Phone:626-289-7856
Practice Address - Fax:626-284-6532
Is Sole Proprietor?:No
Enumeration Date:2006-07-28
Last Update Date:2015-03-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAOPT6533TPA152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist