Healthcare Provider Details

I. General information

NPI: 1558276956
Provider Name (Legal Business Name): AARON WILLIAMS
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/18/2026
Last Update Date: 08/18/2026
Certification Date: 08/18/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3870 MURPHY CANYON RD STE 320
SAN DIEGO CA
92123-4453
US

IV. Provider business mailing address

3732 VIA PICANTE
LA MESA CA
91941-7326
US

V. Phone/Fax

Practice location:
  • Phone: 858-300-0460
  • Fax:
Mailing address:
  • Phone: 619-481-7372
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code175T00000X
TaxonomyPeer Specialist
License NumberMPSS-WIKANC
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: