Healthcare Provider Details

I. General information

NPI: 1336790963
Provider Name (Legal Business Name): LORILEA PAIGE WILLIAMS FNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/25/2019
Last Update Date: 09/27/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

APEX MEDICAL GROUP 890 WEST STETSON AVE # B
HEMET CA
92543
US

IV. Provider business mailing address

37346 PASEO TULIPA
MURRIETA CA
92563-3702
US

V. Phone/Fax

Practice location:
  • Phone: 951-652-2811
  • Fax:
Mailing address:
  • Phone: 601-529-7054
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number95012747
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: