Healthcare Provider Details

I. General information

NPI: 1235277195
Provider Name (Legal Business Name): LYTTON A WILLIAMS M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/02/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2200 W 3RD ST SUITE 120
LOS ANGELES CA
90057-1932
US

IV. Provider business mailing address

2200 W 3RD ST SUITE 120
LOS ANGELES CA
90057-1932
US

V. Phone/Fax

Practice location:
  • Phone: 213-207-5635
  • Fax: 213-207-5889
Mailing address:
  • Phone: 213-207-5635
  • Fax: 213-207-5889

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207XS0117X
TaxonomyOrthopaedic Surgery of the Spine Physician
License NumberG40156
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: