Provider Demographics
NPI:1740257542
Name:RUMACK, WILLIAM ALLEN (MD)
Entity type:Individual
Prefix:DR
First Name:WILLIAM
Middle Name:ALLEN
Last Name:RUMACK
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:7345 MEDICAL CENTER DR
Mailing Address - Street 2:SUITE #280
Mailing Address - City:WEST HILLS
Mailing Address - State:CA
Mailing Address - Zip Code:91307-1937
Mailing Address - Country:US
Mailing Address - Phone:818-888-2855
Mailing Address - Fax:818-888-0702
Practice Address - Street 1:7345 MEDICAL CENTER DR
Practice Address - Street 2:SUITE #280
Practice Address - City:WEST HILLS
Practice Address - State:CA
Practice Address - Zip Code:91307-1937
Practice Address - Country:US
Practice Address - Phone:818-888-2855
Practice Address - Fax:818-888-0702
Is Sole Proprietor?:Yes
Enumeration Date:2006-03-01
Last Update Date:2023-05-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXK2785207X00000X
CODR38255207X00000X
CAA79561207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA1104410001OtherMEDICARE DME SUPPLIER #
CA955118OtherQME #
CODR 38255OtherMEDICAL BOARD OF COLORADO
CAA79561OtherMEDICAL BOARD OF CA
TXK2785OtherMEDICAL BOARD OF TEXAS
CAW8424Medicaid
CAWA79561BOtherMEDICARE PERFORMING
CA953718732OtherTAX ID #
CAW8424Medicaid
CAA79561OtherMEDICAL BOARD OF CA
CAW10980Medicare ID - Type UnspecifiedMEDICARE PROVIDER#(GROUP)