DR. WILLIAM C INCISO (NPI# 1407050289) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1407050289 |
| Entity Type | Individual |
| Full Name | DR. WILLIAM C INCISO |
| Credential | PA-C, PHD |
| Practice Address |
2101 N Waterman Ave San Bernardino CA 92404-4836 |
| Mailing Address |
11855 Briarrose Ln Chino CA 91710-2040 |
| Practice Telephone | 9098817605 |
| Mailing Telephone | 9094552368 |
| Enumeration Date | 2007-06-13 |
| Last Update Date | 2016-08-12 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363A00000X | Physician Assistant | PA 15861 | CA | Physician Assistants & Advanced Practice Nursing Providers |
| Street Address |
2101 N WATERMAN AVE |
| City | SAN BERNARDINO |
| State | CA |
| Zip Code | 92404-4836 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1992797153 | Young A Suk | Anesthesiology | 2101 N Waterman Ave, San Bernardino, CA 92404-4836 | 2005-08-15 |
| 1467077016 | Melissa Magdangal | Occupational Therapist | 2101 N Waterman Ave, San Bernardino, CA 92404-4836 | 2020-06-10 |
| 1902433303 | Ariel Chen | Physician Assistant | 2101 N Waterman Ave, San Bernardino, CA 92404-4836 | 2020-03-25 |
| 1417581059 | Western Acute Care Surgeons Inc | Surgery | 2101 N Waterman Ave, San Bernardino, CA 92404-4836 | 2020-02-22 |
| 1538704234 | Michelle Dela Cruz Villanueva | Occupational Therapist | 2101 N Waterman Ave, San Bernardino, CA 92404-4836 | 2019-11-17 |
| 1750943668 | Benjamin Arthur Rinard | Physician Assistant | 2101 N Waterman Ave, San Bernardino, CA 92404-4836 | 2019-07-01 |
| 1679132955 | Louis Gallo | Physician Assistant | 2101 N Waterman Ave, San Bernardino, CA 92404-4836 | 2019-06-10 |
| 1154984706 | Antonio Moreno | Anesthesiology | 2101 N Waterman Ave, San Bernardino, CA 92404-4836 | 2019-04-18 |
| 1003378944 | Miranda G Ideal | Nurse Anesthetist, Certified Registered | 2101 N Waterman Ave, San Bernardino, CA 92404-4836 | 2019-04-01 |
| 1225599780 | Kylie Brenna Leeper | Dietitian, Registered | 2101 N Waterman Ave, San Bernardino, CA 92404-4836 | 2019-03-27 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1740849363 | Danniella Alexandra Murillo | Physician Assistant | 2101 North Waterman Ave, San Bernardino, CA 92404 | 2019-06-07 |
| 1902377484 | Shauntel Renee Nelson | Student in an Organized Health Care Education/Training Program | 1481 N. Windsor Dr., San Bernardino, CA 92404 | 2018-12-10 |
| 1487123584 | Garrett M Grigg | Licensed Psychiatric Technician | 1481 N Windsor Dr, San Bernardino, CA 92404 | 2018-11-19 |
| 1881163434 | James Dean Anders | Counselor | 1481 Windsor Drive, San Bernardino, CA 92404 | 2018-11-13 |
| 1043703564 | Samantha Makpaiboonvatana | Optometrist | 1909 N Waterman Ave Ste 3, San Bernardino, CA 92404 | 2018-06-09 |
| 1861981623 | Christopher Windham | Behavior Technician | 2460 Fremontia Dr, San Bernardino, CA 92404 | 2018-05-08 |
| 1891145041 | Cynthia Lusy Gastelum | Marriage & Family Therapist | 1885 E Lynwood Dr Rm Se3, San Bernardino, CA 92404 | 2016-06-20 |
| 1336598259 | Foundation Enterprises LLC | Non-emergency Medical Transport (VAN) | 1663 Date Pl., #30390, San Bernardino, CA 92404 | 2016-06-10 |
| 1881042877 | Helen Ann Thompson | Speech-Language Pathologist | 1311 E. State St., San Bernardo, CA 92404 | 2016-05-31 |
| 1366839938 | Lanecia Richardson | Counselor | 135 Paul Drive, San Rafeal, CA 92404 | 2015-04-22 |
| Find all providers in zip 92404 | ||||
| Taxonomy Code | 363A00000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Physician Assistant |
| A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, order lab tests and x-rays, and give inoculations. Most states require that they work under the supervision of a physician. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1740849363 | Danniella Alexandra Murillo | Physician Assistant | 2101 North Waterman Ave, San Bernardino, CA 92404 | 2019-06-07 |
| 1265828370 | Tammy Darby | Physician Assistant | 1918 Business Center Dr Ste 110, San Bernardino, CA 92408-3471 | 2015-04-15 |
| 1275971079 | Brian K Jarman | Physician Assistant | 4905 N Berkeley Ave, San Bernardino, CA 92407-3015 | 2013-06-13 |
| 1437402765 | John Finley | Physician Assistant | 4378 Sepulveda Ave, Apt 11, San Bernardino, CA 92404-1274 | 2012-10-24 |
| 1275813370 | Daniel Kim | Physician Assistant | 1505 W. 17th St, San Bernardino, CA 92411-2661 | 2011-08-19 |
| 1417259268 | Elda Ilia | Physician Assistant | 1800 Medical Center Dr Ste 99, San Bernardino, CA 92411-1232 | 2010-11-30 |
| 1336396548 | Brenitta Gilliam-udo | Physician Assistant | 351 N Mountain View Ave, San Bernardino, CA 92415-1018 | 2008-08-20 |
| 1285806794 | Miguel Trujillo | Physician Assistant | 685 Carnegie Dr Ste 230, San Bernardino, CA 92408-3583 | 2008-03-25 |
| 1629146881 | Lorelie Tolentino | Physician Assistant | 1873 Commercenter West, San Bernardino, CA 92408 | 2006-12-04 |
| 1861582314 | Cecilia Talpa Quinones | Physician Assistant | 565 N. Mount Vernon Ave., San Bernardino, CA 92411 | 2006-10-13 |
| Find all providers in SAN BERNARDINO | ||||
| City | SAN BERNARDINO |
| Zip Code | 92404 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.