MEDICARE: DR. ERNEST RANDALL WILLIAMSON D.C.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	111N00000X	Chiropractor	33218	CA

General Provider Information

NPI Number	:	1891188363
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. ERNEST RANDALL WILLIAMSON D.C.

Provider Business Mailing Address
First Line	:	780 ROSE RANCH RD
Second Line	:
City	:	SAN MARCOS
State	:	CA
Zip	:	92069-1121
Country	:	US
Telephone Number	:	910-264-6977
Fax Number	:

Provider Business Practice Location Address
First Line	:	1878 W EL NORTE PKWY
Second Line	:
City	:	ESCONDIDO
State	:	CA
Zip	:	92026-3343
Country	:	US
Telephone Number	:	760-741-7110
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/09/2015
Last Update Date	:	04/20/2015

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