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NPI Code Detail

MEDICARE: CHARVINA WILLIAMS

MEDICARE:   CHARVINA  WILLIAMS
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1172A00000XDriver

General Provider Information

NPI Number : 1225739998
Entity Type Code : Individual
Provider Name (Legal Business Name) : CHARVINA WILLIAMS
Provider Business Mailing Address
First Line : 1308 E COLORADO BLVD STE 2086
Second Line :
City : PASADENA
State : CA
Zip : 91106-1932
Country : US
Telephone Number : 626-842-0840
Fax Number :
Provider Business Practice Location Address
First Line : 115 E DEL MAR BLVD UNIT 305
Second Line :
City : PASADENA
State : CA
Zip : 91105-2570
Country : US
Telephone Number : 626-842-0840
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/10/2023
Last Update Date : 03/10/2023

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Directions to “ CHARVINA WILLIAMS ” Practice Location

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