MEDICARE: DR. ERIK JAN WILLIAMS MD

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	207W00000X	Ophthalmology Physician	A23475	CA

General Provider Information

NPI Number	:	1568540417
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. ERIK JAN WILLIAMS MD

Provider Business Mailing Address
First Line	:	36921 COOK ST
Second Line	:	SUITE #103
City	:	PALM DESERT
State	:	CA
Zip	:	92211-6070
Country	:	US
Telephone Number	:	760-568-3111
Fax Number	:	760-836-1151

Provider Business Practice Location Address
First Line	:	36921 COOK ST
Second Line	:	SUITE #103
City	:	PALM DESERT
State	:	CA
Zip	:	92211-6070
Country	:	US
Telephone Number	:	760-568-3111
Fax Number	:	760-836-1151

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

Provider Enumeration Date	:	11/01/2006
Last Update Date	:	06/03/2008

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