Individual provider Active NPI

William Coke Harrell, MD

  • Internal Medicine Physician
  • Los Alamitos, CA
National Provider Identifier
1083673685
Registry record updated Oct 11, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
G64492 Issued in CA
Practice address
10861 Cherry St Ste 209
Los Alamitos, CA 90720-5407
Phone
(310) 948-5903
Fax
(310) 315-7933
NPI assigned
Mar 22, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 11, 2024

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X G64492 CA Primary

Addresses

Primary practice location

10861 Cherry St Ste 209
Los Alamitos, CA 90720-5407

Mailing address

2118 Wilshire Blvd
#1122
Santa Monica, CA 90403-5704
Phone (310) 315-7922

Other identifiers 2

IdentifierTypeStateIssuer
00G644921OtherCAMEDI-CAL
G64492OtherCAANTHEM

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040406001066 CA Practitioner - Internal Medicine 9133112089 Practice locations: Los Alamitos, CA

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
64492CAMDDentist

Practice roles

OrganizationSpecialtyStatusNew patients
Monarqui Aesthetic and Wellness CurrentSince Dec 15, 2024 Accepting new patients
Linda T. Wang M.D., Inc CurrentSince Oct 13, 2024 Accepting new patients

Locations

10861 Cherry St
Ste 209
Los Alamitos, CA 90720
Phone (310) 948-5903

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1142985600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1728604800000",
    "number": "1083673685",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2118 WILSHIRE BLVD",
            "address_2": "#1122",
            "city": "SANTA MONICA",
            "state": "CA",
            "postal_code": "904035704",
            "telephone_number": "310-315-7922",
            "fax_number": "310-315-7933"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10861 CHERRY ST STE 209",
            "city": "LOS ALAMITOS",
            "state": "CA",
            "postal_code": "907205407",
            "telephone_number": "310-948-5903",
            "fax_number": "310-315-7933"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HARRELL",
        "first_name": "WILLIAM",
        "middle_name": "COKE",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-03-22",
        "last_updated": "2024-10-11",
        "certification_date": "2024-10-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "CA",
            "license": "G64492",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDI-CAL",
            "identifier": "00G644921",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM",
            "identifier": "G64492",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Los Alamitos, CA

Sources for this page

Verify at the official NPI Registry.