Provider Demographics
NPI:1285620666
Name:WARSHAL, WILLIAM S (MD)
Entity type:Individual
Prefix:
First Name:WILLIAM
Middle Name:S
Last Name:WARSHAL
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15251 NATIONAL AVE STE 104
Mailing Address - Street 2:
Mailing Address - City:LOS GATOS
Mailing Address - State:CA
Mailing Address - Zip Code:95032-2400
Mailing Address - Country:US
Mailing Address - Phone:408-605-8612
Mailing Address - Fax:650-631-2448
Practice Address - Street 1:15251 NATIONAL AVE STE 104
Practice Address - Street 2:
Practice Address - City:LOS GATOS
Practice Address - State:CA
Practice Address - Zip Code:95032-2400
Practice Address - Country:US
Practice Address - Phone:408-605-8612
Practice Address - Fax:650-631-2448
Is Sole Proprietor?:Yes
Enumeration Date:2005-09-21
Last Update Date:2024-05-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG41468207QG0300X, 207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
No207QG0300XAllopathic & Osteopathic PhysiciansFamily MedicineGeriatric Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00G414681Medicaid
CA00G414681Medicaid
CA00G414680Medicare ID - Type UnspecifiedSAMARITAN FAMILY PRACTICE
CA00G414681Medicare ID - Type UnspecifiedGERIATRIC PRACTICE