Provider / Organization | NPI | Date Certified |
---|---|---|
WILLIAM KEN MCCALLUM | 1831658806 | 2022-10-01 |
William Ken Mccallum is registered with the National Plan and Provider Enumeration System and has been issued an National Provider Identifier (NPI) of 1831658806. Registration indicates William Ken Mccallum is a provider of services with a specialization in Other Service Providers, Military Health Care Provider (Military Health Care Provider, ) (Military Health Care Provider, Other Service Providers) (Student, Health Care, Student in an Organized Health Care Education/Training Program) (Student in an Organized Health Care Education/Training Program, ) (All Other Specialties & Provider Types, ) (Student in an Organized Health Care Education/Training Program, Student, Health Care) (Emergency Medicine, ) (Allopathic & Osteopathic Physicians, Emergency Medicine) (All Other Specialties & Provider Types, ) (Emergency Medicine, Allopathic & Osteopathic Physicians)
Entity Type | Individual |
Provider Name | William Ken Mccallum MD |
Practice Office Address | 60 MDG/SGGE 101 BODIN CIRCLE TRAVIS AFB, CA US |
Practice Office Telephone | 7074233825 |
Mailing Address | 101 BODIN CIR TRAVIS AFB, CA 945351809 US |
Address | City / State | Phone / Fax |
---|---|---|
2315 Stockton Blvd | Sacramento, CA 958172201 | 9167345010 / 9167347950 |
Carequality [C-CDA] | https://careepicwest.kp.org:14430/Interconnect-prodcalgateway/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/ncalceq | Health Information Exchange (HIE) |
Code | Practice | License No State |
---|---|---|
171000000X | Other Service Providers Military Health Care Provider Military Health Care Provider Military Health Care Provider Other Service Providers | |
390200000X | Student, Health Care Student in an Organized Health Care Education/Training Program Student in an Organized Health Care Education/Training Program All Other Specialties & Provider Types Student in an Organized Health Care Education/Training Program Student, Health Care | |
207P00000X PRIMARY | Emergency Medicine Allopathic & Osteopathic Physicians Emergency Medicine All Other Specialties & Provider Types Emergency Medicine Allopathic & Osteopathic Physicians | 178163
CA |