Provider Demographics
NPI:1841243508
Name:MCDONALD, WILLIAM JOSEPH JR (OD)
Entity type:Individual
Prefix:
First Name:WILLIAM
Middle Name:JOSEPH
Last Name:MCDONALD
Suffix:JR
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5500 MING AVE
Mailing Address - Street 2:SUITE 175
Mailing Address - City:BAKERSFIELD
Mailing Address - State:CA
Mailing Address - Zip Code:93309-4623
Mailing Address - Country:US
Mailing Address - Phone:661-832-8990
Mailing Address - Fax:661-832-9011
Practice Address - Street 1:5500 MING AVE
Practice Address - Street 2:SUITE 175
Practice Address - City:BAKERSFIELD
Practice Address - State:CA
Practice Address - Zip Code:93309-4623
Practice Address - Country:US
Practice Address - Phone:661-832-8990
Practice Address - Fax:661-832-9011
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-17
Last Update Date:2008-11-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA5181T152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CASD0051810Medicaid
CASD0051810Medicaid
CA$$$$$$$$$Medicare PIN
T09896Medicare UPIN