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General NPI Number Information
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NPI Number | 1528241593
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Entity Type | Individual
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Provider Name | PRESTON LANDON WILLIAMS PA-C
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Gender | Male
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Dates
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Enumeration Date | 12/12/2007
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Last Update Date | 10/18/2016
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Provider Practice Location Address
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Address Line | 14850 OKA RD APT 5
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City | LOS GATOS
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State | CA
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Zip | 95032-1926
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Country | US
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Telephone | 415-840-5970
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Fax |
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Provider Business Mailing Address
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Address Line | 1001 SILK OAK CT
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City | SUISUN CITY
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State | CA
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Zip | 94585
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Country | US
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Telephone | 415-840-5970
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | PA19624
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License Number State | CA
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