Provider Demographics
NPI:1831172659
Name:PEVEC, WILLIAM CHARLES (MD)
Entity type:Individual
Prefix:DR
First Name:WILLIAM
Middle Name:CHARLES
Last Name:PEVEC
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Gender:M
Credentials:MD
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Mailing Address - Street 1:2221 STOCKTON BLVD
Mailing Address - Street 2:2ND FLOOR
Mailing Address - City:SACRAMENTO
Mailing Address - State:CA
Mailing Address - Zip Code:95817-1418
Mailing Address - Country:US
Mailing Address - Phone:916-734-3524
Mailing Address - Fax:916-734-7205
Practice Address - Street 1:2221 STOCKTON BLVD
Practice Address - Street 2:2ND FLOOR
Practice Address - City:SACRAMENTO
Practice Address - State:CA
Practice Address - Zip Code:95817-1418
Practice Address - Country:US
Practice Address - Phone:916-734-3524
Practice Address - Fax:916-734-7205
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-11-25
Last Update Date:2023-03-07
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Provider Licenses
StateLicense IDTaxonomies
CAG0761482086S0129X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2086S0129XAllopathic & Osteopathic PhysiciansSurgeryVascular Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAG076148OtherCA MEDICAL LICENSE
CAG076148OtherCA MEDICAL LICENSE
CABP0278817OtherDEA CERTIFICATE