Individual
WILLIAM CHARLES ANDREW HALL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
2141 N HARBOR BLVD, SUITE 35000, FULLERTON, CA 92835
(714) 626-8630
(714) 626-8659
Mailing address
2141 N HARBOR BLVD STE 35000, FULLERTON, CA 92835-3831
Taxonomy
Speciality
Code
Description
License number
State
363AS0400X
Surgical Physician Assistant
085-002096
IL
363AS0400X
Surgical Physician Assistant
Primary
PA23284
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
085002096
BLUE CROSS/BLUE SHIELD PROVIDER NUMBER
IL
Enumeration date
05/18/2006
Last updated
11/03/2021
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