Provider Demographics
NPI:1750524658
Name:FLANAGAN, WILLIAM S III (LAC)
Entity type:Individual
Prefix:DR
First Name:WILLIAM
Middle Name:S
Last Name:FLANAGAN
Suffix:III
Gender:M
Credentials:LAC
Other - Prefix:
Other - First Name:
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Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:627 MALABAR DR
Mailing Address - Street 2:
Mailing Address - City:CORONA DEL MAR
Mailing Address - State:CA
Mailing Address - Zip Code:92625-1838
Mailing Address - Country:US
Mailing Address - Phone:949-244-5170
Mailing Address - Fax:
Practice Address - Street 1:2600 E COAST HWY
Practice Address - Street 2:SUITE 150
Practice Address - City:CORONA DEL MAR
Practice Address - State:CA
Practice Address - Zip Code:92625-2117
Practice Address - Country:US
Practice Address - Phone:949-244-5170
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-04-08
Last Update Date:2009-04-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA8590171100000X
HI659171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist