William Elwood Defazio, PA-C

Primary specialty

Medical Physician AssistantTaxonomy code 363AM0700X

License

PA 19321 Issued in CA

Practice address

3911 Norwood Ave
Sacramento, CA 95838-3361

Phone

(916) 929-8575

NPI assigned

Sep 6, 2007

Last updated

Sep 6, 2007By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

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

• Elk Grove Urgent Care

  • Urgent Care Clinic/Center
  • Sacramento, CA
  • NPI 1013214527
  NPD (past)

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

{
    "created_epoch": "1189036800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1189036800000",
    "number": "1184819807",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3911 NORWOOD AVE",
            "city": "SACRAMENTO",
            "state": "CA",
            "postal_code": "958383361",
            "telephone_number": "916-929-8575"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3911 NORWOOD AVE",
            "city": "SACRAMENTO",
            "state": "CA",
            "postal_code": "958383361",
            "telephone_number": "916-929-8575"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DEFAZIO",
        "first_name": "WILLIAM",
        "middle_name": "ELWOOD",
        "name_prefix": "Mr.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-09-06",
        "last_updated": "2007-09-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "CA",
            "license": "PA 19321",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Deeper Cuts, LLC
• Barry Cebon Deer, PH.D
• Nancy Ann Deer, LMFT
• Jacob Dees, CRNA
• Elizabeth Defazio
• Nathaniel Richard Defelice, M.D.
• Richard David Defelice, M.D.
• Defender, LLC (Saylor Lane Healthcare Center)
• Colette Defilippo, MS
• Defining Beauty Permanent Cosmetics

• Medical Physician Assistant in Sacramento, CA
• Providers in Sacramento, CA by specialty
• Medical Physician Assistant in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 6, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.