Healthcare Provider Details

I. General information

NPI: 1104579184
Provider Name (Legal Business Name): SHAUN RELAUNT WILLIAMS II MD, MPH
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/31/2022
Last Update Date: 08/03/2025
Certification Date: 08/03/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

38400 BOB WILSON DR NAVAL MEDICAL CENTER SAN DIEGO
SAN DIEGO CA
92134-5000
US

IV. Provider business mailing address

38400 BOB WILSON DR NAVAL MEDICAL CENTER SAN DIEGO
SAN DIEGO CA
92134-5000
US

V. Phone/Fax

Practice location:
  • Phone: 619-852-8509
  • Fax:
Mailing address:
  • Phone: 619-852-8509
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code171000000X
TaxonomyMilitary Health Care Provider
License Number0101279299
License Number StateVA
# 2
Primary TaxonomyY
Taxonomy Code171000000X
TaxonomyMilitary Health Care Provider
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: