MEDICARE: MRS. LILITH 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
1	171M00000X	Case Manager/Care Coordinator

General Provider Information

NPI Number	:	1831333244
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. LILITH WILLIAMS

Provider Business Mailing Address
First Line	:	1665 SCENIC AVE.
Second Line	:	SUITE 100
City	:	COSTA MESA
State	:	CA
Zip	:	92626
Country	:	US
Telephone Number	:	562-491-5811
Fax Number	:	562-435-8563

Provider Business Practice Location Address
First Line	:	415 W OCEAN BLVD
Second Line	:	100
City	:	LONG BEACH
State	:	CA
Zip	:	90802-4512
Country	:	US
Telephone Number	:	562-491-5811
Fax Number	:	562-435-8563

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

Provider Enumeration Date	:	04/29/2009
Last Update Date	:	02/15/2012

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