Provider Demographics
NPI:1336201011
Name:VON KAENEL, WILLIAM EDWARD II (MD)
Entity Type:Individual
Prefix:DR
First Name:WILLIAM
Middle Name:EDWARD
Last Name:VON KAENEL
Suffix:II
Gender:M
Credentials:MD
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:6121 N THESTA ST
Mailing Address - Street 2:STE. 106
Mailing Address - City:FRESNO
Mailing Address - State:CA
Mailing Address - Zip Code:93710-8603
Mailing Address - Country:US
Mailing Address - Phone:559-435-1846
Mailing Address - Fax:559-435-0127
Practice Address - Street 1:6121 N THESTA ST
Practice Address - Street 2:STE. 106
Practice Address - City:FRESNO
Practice Address - State:CA
Practice Address - Zip Code:93710-8603
Practice Address - Country:US
Practice Address - Phone:559-435-1846
Practice Address - Fax:559-435-0127
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-15
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CAG69164207LP2900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207LP2900XAllopathic & Osteopathic PhysiciansAnesthesiologyPain Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA63919Medicare UPIN