Provider Demographics
NPI:1407869167
Name:MARKOFF, WILLIAM AARON (MD)
Entity Type:Individual
Prefix:
First Name:WILLIAM
Middle Name:AARON
Last Name:MARKOFF
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:3536 MENDOCINO AVE
Mailing Address - Street 2:STE 200
Mailing Address - City:SANTA ROSA
Mailing Address - State:CA
Mailing Address - Zip Code:95403-3634
Mailing Address - Country:US
Mailing Address - Phone:707-525-6485
Mailing Address - Fax:707-544-0128
Practice Address - Street 1:3536 MENDOCINO AVE STE 300
Practice Address - Street 2:
Practice Address - City:SANTA ROSA
Practice Address - State:CA
Practice Address - Zip Code:95403-3634
Practice Address - Country:US
Practice Address - Phone:707-544-3811
Practice Address - Fax:707-544-0128
Is Sole Proprietor?:No
Enumeration Date:2006-08-14
Last Update Date:2021-11-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA74621207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00A746210OtherBS OF CALIFORNIA
CAP00653930OtherRAILROAD MEDICARE
CA1407869167Medicaid
CAAR120ZMedicare PIN
CA1407869167Medicaid