Provider Demographics
NPI:1619048261
Name:UMANSKY, WILLIAM STEVEN (MD)
Entity Type:Individual
Prefix:
First Name:WILLIAM
Middle Name:STEVEN
Last Name:UMANSKY
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:WILLIAM
Other - Middle Name:S
Other - Last Name:UMANSKY
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MD
Mailing Address - Street 1:4150 REGENTS PARK ROW
Mailing Address - Street 2:260
Mailing Address - City:LA JOLLA
Mailing Address - State:CA
Mailing Address - Zip Code:92037
Mailing Address - Country:US
Mailing Address - Phone:858-550-9697
Mailing Address - Fax:858-550-9698
Practice Address - Street 1:4150 REGENTS PARK ROW
Practice Address - Street 2:260
Practice Address - City:LA JOLLA
Practice Address - State:CA
Practice Address - Zip Code:92037
Practice Address - Country:US
Practice Address - Phone:858-550-9697
Practice Address - Fax:858-550-9698
Is Sole Proprietor?:No
Enumeration Date:2006-11-13
Last Update Date:2010-08-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG067858208200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208200000XAllopathic & Osteopathic PhysiciansPlastic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
F24188Medicare UPIN
CAG67858Medicare ID - Type Unspecified