Provider Demographics
NPI:1669461745
Name:PARENT, WILLIAM CHARLES (PA)
Entity Type:Individual
Prefix:MR
First Name:WILLIAM
Middle Name:CHARLES
Last Name:PARENT
Suffix:
Gender:M
Credentials:PA
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Mailing Address - Street 1:28889 CRYSTAL CAVE CT
Mailing Address - Street 2:
Mailing Address - City:COARSEGOLD
Mailing Address - State:CA
Mailing Address - Zip Code:93614-9696
Mailing Address - Country:US
Mailing Address - Phone:559-641-6004
Mailing Address - Fax:
Practice Address - Street 1:23638 SKY HARBOUR ROAD
Practice Address - Street 2:
Practice Address - City:FRIANT
Practice Address - State:CA
Practice Address - Zip Code:93626
Practice Address - Country:US
Practice Address - Phone:559-822-3785
Practice Address - Fax:559-822-2928
Is Sole Proprietor?:No
Enumeration Date:2005-10-20
Last Update Date:2007-09-18
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
CA11917363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical