Provider Demographics
NPI:1013288323
Name:NELSON, WILLIAM LOWELL JR (MD)
Entity Type:Individual
Prefix:DR
First Name:WILLIAM
Middle Name:LOWELL
Last Name:NELSON
Suffix:JR
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13439 CALLE COLINA
Mailing Address - Street 2:
Mailing Address - City:POWAY
Mailing Address - State:CA
Mailing Address - Zip Code:92064-1608
Mailing Address - Country:US
Mailing Address - Phone:858-385-9064
Mailing Address - Fax:
Practice Address - Street 1:13439 CALLE COLINA
Practice Address - Street 2:
Practice Address - City:POWAY
Practice Address - State:CA
Practice Address - Zip Code:92064-1608
Practice Address - Country:US
Practice Address - Phone:858-385-9064
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-01-18
Last Update Date:2012-01-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAC34999207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology