Provider Demographics
NPI:1992875959
Name:ENGEL, WILLIAM KING (MD)
Entity type:Individual
Prefix:DR
First Name:WILLIAM
Middle Name:KING
Last Name:ENGEL
Suffix:
Gender:M
Credentials:MD
Other - Prefix:DR
Other - First Name:W
Other - Middle Name:KING
Other - Last Name:ENGEL
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD
Mailing Address - Street 1:637 SOUTH LUCAS AVE.
Mailing Address - Street 2:3RD FLOOR
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90017-1912
Mailing Address - Country:US
Mailing Address - Phone:213-975-9950
Mailing Address - Fax:213-975-9955
Practice Address - Street 1:637 SOUTH LUCAS AVE.
Practice Address - Street 2:3RD FLOOR
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90017-1912
Practice Address - Country:US
Practice Address - Phone:213-975-9950
Practice Address - Fax:213-975-9955
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-08
Last Update Date:2013-11-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG446192084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAG44619OtherSTATE LICENSE
CAWG44619AMedicare PIN