Active NPI
William David Holder, PHYSICIAN ASSISTANT
- Physician Assistant
- El Cajon, CA
National Provider Identifier
1699816256
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- License
- 14647
- Practice address
- 133 W Main St Ste 100
El Cajon, CA 92020-3325 - Phone
- (619) 401-0404
- NPI assigned
- Feb 8, 2007
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | 14647 | CA | Primary |
Addresses
Primary practice location
133 W Main St Ste 100
El Cajon, CA 92020-3325
Mailing address
34800 Bob Wilson Dr
Nmcsd Attn Medical
San Diego, CA 92134-1098
Phone (619) 532-6460
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 14647 | CA | MD | Addiction (Substance Use Disorder) Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1170892800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1432684800000",
"number": "1699816256",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "34800 BOB WILSON DR",
"address_2": "NMCSD ATTN MEDICAL",
"city": "SAN DIEGO",
"state": "CA",
"postal_code": "921341098",
"telephone_number": "619-532-6460",
"fax_number": "619-532-6299"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "133 W MAIN ST STE 100",
"city": "EL CAJON",
"state": "CA",
"postal_code": "920203325",
"telephone_number": "619-401-0404"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HOLDER",
"first_name": "WILLIAM",
"middle_name": "DAVID",
"name_prefix": "Mr.",
"credential": "PHYSICIAN ASSISTANT",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2007-02-08",
"last_updated": "2015-05-27",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "CA",
"license": "14647",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in El Cajon, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 27, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.