Provider Demographics
NPI:1215915293
Name:ARROWHEAD - OB-GYN
Entity type:Organization
Organization Name:ARROWHEAD - OB-GYN
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT ARROWHEAD OB GYN
Authorized Official - Prefix:DR
Authorized Official - First Name:WILLIAM
Authorized Official - Middle Name:H
Authorized Official - Last Name:DESCHNER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:909-336-2156
Mailing Address - Street 1:PO BOX 1570
Mailing Address - Street 2:
Mailing Address - City:LAKE ARROWHEAD
Mailing Address - State:CA
Mailing Address - Zip Code:92352-1570
Mailing Address - Country:US
Mailing Address - Phone:909-336-2156
Mailing Address - Fax:909-336-0507
Practice Address - Street 1:29099 HOSPITAL RD
Practice Address - Street 2:STE 114
Practice Address - City:LAKE ARROWHEAD
Practice Address - State:CA
Practice Address - Zip Code:92352-1570
Practice Address - Country:US
Practice Address - Phone:909-336-2156
Practice Address - Fax:909-336-0507
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-01-09
Last Update Date:2009-04-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAC50030207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00C500300Medicaid
ZZZ31777ZMedicare ID - Type Unspecified
CA00C500300Medicaid