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General NPI Number Information
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NPI Number | 1538477716
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Entity Type | Individual
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Provider Name | GARTH RICHARD WILLIAMS RN
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Gender | Male
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Dates
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Enumeration Date | 09/21/2010
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Last Update Date | 09/21/2010
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Provider Practice Location Address
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Address Line | 303 POTRERO ST
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City | SANTA CRUZ
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State | CA
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Zip | 95060-2741
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Country | US
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Telephone | 831-466-9307
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Fax | 831-466-9748
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Provider Business Mailing Address
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Address Line | PO BOX 5182
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City | SANTA CRUZ
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State | CA
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Zip | 95063-5182
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Country | US
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Telephone | 831-332-1550
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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 | 163W00000X
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Taxonomy Name | Registered Nurse
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License Number | 768633
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License Number State | CA
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