William E Defazio (NPI# 1184819807, PAC ID# 7517094725) is a physician enrolled in Centers for Medicare & Medicaid Services (CMS). The primary specialty is PHYSICIAN ASSISTANT.
| Nation Provider ID (NPI) | 1184819807 |
| PAC ID by PECOS | 7517094725 |
| Professional Enrollment ID | I20100420000755 |
| Full Name | William E Defazio |
| Organization Legal Name | CLINIC SERVICES OF CALIFORNIA MEDICAL GROUP INC |
| Address |
1235 W Vine St Suite 20 Lodi CA 95240-5144 |
| Phone Number | 2093343411 |
| Gender | M |
| Graduation Year | 2007 |
| Primary Specialty | PHYSICIAN ASSISTANT |
| Group Practice PAC ID | 7810209715 |
| Number of Group Practice Members | 50 |
| Accepts Medicare Assignment | Y |
| Claim Control Number (CCN) | Legal Business Name |
|---|---|
| 050336 | ADVENTIST HEALTH LODI MEMORIAL |
| Address | Phone | Organization |
|---|---|---|
| 1235 W Vine St, Suite 20, Lodi, CA 95240-5144 | 2093343411 | CLINIC SERVICES OF CALIFORNIA MEDICAL GROUP INC |
| Organization Legal Name | CLINIC SERVICES OF CALIFORNIA MEDICAL GROUP INC |
| Physicians | 33 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Kristen C Macrae | Nurse Practitioner | Clinic Services of California Medical Group Inc | 1235 W Vine St, Suite 20, Lodi, CA 95240-5144 |
| Xavier Salinas | Emergency Medicine | Clinic Services of California Medical Group Inc | 925 Corporate Cntr Pkwy A, Santa Rosa, CA 95407-5453 |
| Amy E Vu | Physician Assistant | Clinic Services of California Medical Group Inc | 8851 Ctr Dr, Suite 600, La Mesa, CA 91942-3061 |
| Shanon Star Murillo | Physician Assistant | Clinic Services of California Medical Group Inc | 8851 Ctr Dr, Suite 600, La Mesa, CA 91942-3061 |
| Darlene F Tyler | Nurse Practitioner | Clinic Services of California Medical Group Inc | 400 N Pepper Ave, Colton, CA 92324-1801 |
| Elizabeth T Kerlick | Physician Assistant | Clinic Services of California Medical Group Inc | 8851 Ctr Dr, Suite 600, La Mesa, CA 91942-3061 |
| Adam F Prince | Physician Assistant | Clinic Services of California Medical Group Inc | 8851 Ctr Dr, Suite 600, La Mesa, CA 91942-3061 |
| Elizabeth L Tomatsu | Physician Assistant | Clinic Services of California Medical Group Inc | 8851 Ctr Dr, Suite 600, La Mesa, CA 91942-3061 |
| Bethany Lindstrom | Physician Assistant | Clinic Services of California Medical Group Inc | 8851 Ctr Dr, Suite 600, La Mesa, CA 91942-3061 |
| Linda Joanne Lazar | Internal Medicine | Clinic Services of California Medical Group Inc | 400 N Pepper Ave, Colton, CA 92324-1801 |
| Street Address |
1235 W VINE ST SUITE 20 |
| City | LODI |
| State | CA |
| Zip | 95240-5144 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Kristen C Macrae | Nurse Practitioner | Clinic Services of California Medical Group Inc | 1235 W Vine St, Suite 20, Lodi, CA 95240-5144 |
| Yvonne M Cabero | Nurse Practitioner | Clinic Services of California Medical Group Inc | 1235 W Vine St, Suite 20, Lodi, CA 95240-5144 |
| Alexander J Nedopil | Orthopedic Surgery | Lodi Memorial Hospital Association Inc | 1235 W Vine St, Suite 22, Lodi, CA 95240-5144 |
| Brittany G Luiz | Nurse Practitioner | Clinic Services of California Medical Group Inc | 1235 W Vine St, Suite 20, Lodi, CA 95240-5144 |
| Arturo N De Leon | Nurse Practitioner | Lodi Memorial Hospital Association Inc | 1235 W Vine St, Suite 22, Lodi, CA 95240-5144 |
| Levi Gore | Nurse Practitioner | Clinic Services of California Medical Group Inc | 1235 W Vine St, Suite 20, Lodi, CA 95240-5144 |
| Robert A Padilla | Family Practice | Clinic Services of California Medical Group Inc | 1235 W Vine St, Lodi, CA 95240-5144 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Ramnik Singh Clair | Osteopathic Manipulative Medicine | 900 S Fairmont A A, Lodi, CA 95240 | |
| Kharis E Powell | Psychologist, Clinical | 12 S Hutchins St, Lodi, CA 95240-1922 | |
| Sarah A Bozeman | Physical Therapy | Golden Bear Physical Therapy and Sports Injury Center, Inc | 210 W Pine St, Lodi, CA 95240-2020 |
| Zachary Joseph Mertz | Physical Therapy | Golden Bear Physical Therapy and Sports Injury Center, Inc | 210 W Pine St, Lodi, CA 95240-2020 |
| Fatema M Ghani | Physical Therapy | Golden Bear Physical Therapy and Sports Injury Center, Inc | 210 W Pine St, Lodi, CA 95240-2020 |
| Michael R Oconnell | Chiropractic | 404 W Pine St, Suite 14, Lodi, CA 95240-2048 | |
| Toni F Reynolds | Chiropractic | 404 W Pine St, Suite 4, Lodi, CA 95240-2048 | |
| Heather West Leam | Chiropractic | 812 W Lodi Ave, Lodi, CA 95240-3302 | |
| Larry Od Simpfenderfer | Optometry | 1210 W Tokay St, Lodi, CA 95240-3810 | |
| Frank T Huang Jr. | Endocrinology | Adventist Health Physicians Network | 515 S Fairmont Ave, Lodi, CA 95240-3834 |
| Find all physicians in zip 95240 | |||
| City | LODI |
| Zip Code | 95240 |
| Specialty | PHYSICIAN ASSISTANT |
| City + Specialty | LODI + PHYSICIAN ASSISTANT |
Please comment or provide details below to improve the information on William E Defazio.
| Data Provider | Centers for Medicare & Medicaid Services (CMS) |
| Jurisdiction | Medicare |
This dataset includes 1.12 million groups, individual physicians, and other clinicians currently enrolled in Medicare. Each physician is registered with NPI, PAC ID, full name, specialty, phone, organization, hospital, address, medical school, etc.