Individual
WILLIAM D MCDONALD
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DPM
Contact information
Practice address
4722 QUAIL LAKES DR, SUITE A, STOCKTON, CA 95207-5256
(209) 476-0675
(209) 476-9389
Mailing address
4722 QUAIL LAKES DR, SUITE A, STOCKTON, CA 95207-5256
(209) 476-0675
(209) 476-9389
Taxonomy
Speciality
Code
Description
License number
State
213E00000X
Podiatrist
Primary
E3287
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
E3287
STATE LICENSE #
CA
05
—
GRE001670
—
CA
01
—
ZZZ28592Z
MEDICARE - ID
CA
Enumeration date
08/29/2006
Last updated
11/04/2015
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