Healthcare Provider Details

I. General information

NPI: 1710068556
Provider Name (Legal Business Name): RICHARD GARDNER WILLIAMS MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/18/2006
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5901 E SEVENTH ST RADIATION ONCOLOGY 114A
LONG BEACH CA
90822-5201
US

IV. Provider business mailing address

PO BOX 13080
LONG BEACH CA
90803-8080
US

V. Phone/Fax

Practice location:
  • Phone: 562-826-5606
  • Fax: 562-826-5703
Mailing address:
  • Phone: 562-826-5606
  • Fax: 562-826-5703

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207N00000X
TaxonomyDermatology Physician
License NumberG55464
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code2085R0001X
TaxonomyRadiation Oncology Physician
License NumberG55464
License Number StateCA
# 3
Primary TaxonomyN
Taxonomy Code208D00000X
TaxonomyGeneral Practice Physician
License NumberG55464
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: