MEDICARE: MS. ROSALIND J WILLIAMS PA-C

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
1	363AM0700X	Medical Physician Assistant	13988	CA
2	363A00000X	Physician Assistant	PA13988	CA

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	P01272669/DU4032	OTHER	CA	RAILROAD MEDICARE

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1437281979
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. ROSALIND J WILLIAMS PA-C

Provider Business Mailing Address
First Line	:	625 FAIR OAKS AVE STE 270
Second Line	:
City	:	SOUTH PASADENA
State	:	CA
Zip	:	91030-5801
Country	:	US
Telephone Number	:	626-346-2455
Fax Number	:	626-639-3005

Provider Business Practice Location Address
First Line	:	445 E ANAHEIM ST STE H
Second Line	:
City	:	WILMINGTON
State	:	CA
Zip	:	90744-4600
Country	:	US
Telephone Number	:	310-518-6146
Fax Number	:	877-469-1428

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/11/2007
Last Update Date	:	04/02/2018

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