Provider Demographics
NPI:1356346597
Name:WILLE, CATHERINE A (MD)
Entity type:Individual
Prefix:DR
First Name:CATHERINE
Middle Name:A
Last Name:WILLE
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:4011 N FRESNO ST
Mailing Address - Street 2:STE 101
Mailing Address - City:FRESNO
Mailing Address - State:CA
Mailing Address - Zip Code:93726-4028
Mailing Address - Country:US
Mailing Address - Phone:559-227-6691
Mailing Address - Fax:559-227-3765
Practice Address - Street 1:4011 N FRESNO ST
Practice Address - Street 2:STE 101
Practice Address - City:FRESNO
Practice Address - State:CA
Practice Address - Zip Code:93726-4028
Practice Address - Country:US
Practice Address - Phone:559-227-6691
Practice Address - Fax:559-227-3765
Is Sole Proprietor?:Yes
Enumeration Date:2005-06-15
Last Update Date:2014-02-24
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
CAG43660207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00G436600Medicaid
CAA49421Medicare UPIN
CA00G436600Medicaid