Provider Demographics
NPI:1841484649
Name:MCANINCH, WILLIAM E (OD)
Entity type:Individual
Prefix:
First Name:WILLIAM
Middle Name:E
Last Name:MCANINCH
Suffix:
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 1:14006 RIVERSIDE DR
Mailing Address - Street 2:SPACE 274
Mailing Address - City:SHERMAN OAKS
Mailing Address - State:CA
Mailing Address - Zip Code:91423-1945
Mailing Address - Country:US
Mailing Address - Phone:818-461-0595
Mailing Address - Fax:
Practice Address - Street 1:14006 RIVERSIDE DR
Practice Address - Street 2:SPACE 274
Practice Address - City:SHERMAN OAKS
Practice Address - State:CA
Practice Address - Zip Code:91423-1945
Practice Address - Country:US
Practice Address - Phone:818-461-0595
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-09-05
Last Update Date:2007-09-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA13227152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist