Healthcare Provider Details

I. General information

NPI: 1508026246
Provider Name (Legal Business Name): THOMAS G WILLIAMS, MD INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/16/2008
Last Update Date: 07/13/2021
Certification Date: 07/13/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

25495 MEDICAL CENTER DR SUITE 101
MURRIETA CA
92562-5963
US

IV. Provider business mailing address

25470 MEDICAL CENTER DR SUITE 206
MURRIETA CA
92562-4900
US

V. Phone/Fax

Practice location:
  • Phone: 949-588-2190
  • Fax: 951-973-7389
Mailing address:
  • Phone: 949-588-2190
  • Fax: 951-973-7389

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License NumberG68083
License Number StateCA

VIII. Authorized Official

Name: DR. THOMAS G WILLIAMS
Title or Position: PRESIDENT
Credential: M.D.
Phone: 949-588-2190