William F Broeckel, M.D.

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

G53319 Issued in CA

Practice address

475 Bruce St
Yreka, CA 96097-3474

Phone

(530) 841-4980

Fax

(530) 841-4979

NPI assigned

Jul 18, 2006

Last updated

May 24, 2012By 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

Other identifiers 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Medicine

State licenses

Interoperability endpoints

• Direct secure messaging: wbroeckel2459208@oc.providencedirect.org

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

{
    "created_epoch": "1153180800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1337817600000",
    "number": "1659390219",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "475 BRUCE ST",
            "city": "YREKA",
            "state": "CA",
            "postal_code": "960973474",
            "telephone_number": "530-841-4980",
            "fax_number": "530-841-4979"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "475 BRUCE ST",
            "city": "YREKA",
            "state": "CA",
            "postal_code": "960973474",
            "telephone_number": "530-841-4980",
            "fax_number": "530-841-4979"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BROECKEL",
        "first_name": "WILLIAM",
        "middle_name": "F",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-18",
        "last_updated": "2012-05-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "CA",
            "license": "G53319",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00G53319",
            "state": "CA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "RHM53948F",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Braden Partners LP (Pacific Pulmonary Services)
• Charity Ann Bradley, FNP
• Kathleen Brandt, FNP
• Edith E Broce
• Judy P Broeckel, M.D.
• Cora Ann Brownell, RN
• Gwen Anne Brush, LVN
• Mallory Bryan
• Steven John Bulcroft, STEVEN BULCROFT
• Scott Bury, MA

• Pediatrics Physician in Yreka, CA
• Providers in Yreka, CA by specialty
• Pediatrics Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 24, 2012; 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.