Healthcare Provider Details

I. General information

NPI: 1740749951
Provider Name (Legal Business Name): EVA ADANNA WILLIAMS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/18/2019
Last Update Date: 08/14/2026
Certification Date: 08/14/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9025 WILSHIRE BLVD STE 202
BEVERLY HILLS CA
90211-1825
US

IV. Provider business mailing address

1200 N STATE ST CLINIC TOWER, SUITE A7D
LOS ANGELES CA
90033-1029
US

V. Phone/Fax

Practice location:
  • Phone: 786-495-7676
  • Fax: 310-602-6426
Mailing address:
  • Phone: 786-495-7676
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208200000X
TaxonomyPlastic Surgery Physician
License NumberA178599
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: