Basic Information
Provider Information
NPI: 1487009460
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: TEMPLE
FirstName: WILLIAM
MiddleName:  
NamePrefix: MR.
NameSuffix:  
Credential:  
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 550 16TH ST
Address2: 4TH FLOOR, 4551, BOX 0110
City: SAN FRANCISCO
State: CA
PostalCode: 941432549
CountryCode: US
TelephoneNumber:  
FaxNumber:  
Practice Location
Address1: 550 16TH ST
Address2: 4TH FLOOR, 4551, BOX 0110
City: SAN FRANCISCO
State: CA
PostalCode: 941432549
CountryCode: US
TelephoneNumber: 4154766245
FaxNumber: 4154765354
Other Information
ProviderEnumerationDate: 04/27/2016
LastUpdateDate: 07/08/2022
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 07/08/2022

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
2080P0207XA155787CAY Allopathic & Osteopathic PhysiciansPediatricsPediatric Hematology-Oncology

No ID Information.


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