1386884062 NPI number — DR. AARON THERESA WILLIAMS D.C.

Table of content: DR. AARON THERESA WILLIAMS D.C. (NPI 1386884062)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1386884062 NPI number — DR. AARON THERESA WILLIAMS D.C.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
WILLIAMS
Provider First Name:
AARON
Provider Middle Name:
THERESA
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
D.C.
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
ROBINSON
Provider Other First Name:
AARON
Provider Other Middle Name:
THERESA
Provider Other Name Prefix Text:
MISS
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:
1

NPI Number Information

NPI Number:
1386884062
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
11/12/2013
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
2052 LAKE AVE
Provider Second Line Business Mailing Address:
SUITE E
Provider Business Mailing Address City Name:
ALTADENA
Provider Business Mailing Address State Name:
CA
Provider Business Mailing Address Postal Code:
91001-2460
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
626-797-3602
Provider Business Mailing Address Fax Number:
626-797-9669

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
2052 LAKE AVE
Provider Second Line Business Practice Location Address:
SUITE E
Provider Business Practice Location Address City Name:
ALTADENA
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
91001-2460
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
626-797-3602
Provider Business Practice Location Address Fax Number:
626-797-9669
Provider Enumeration Date:
02/20/2009

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 111N00000X , with the licence number:  DC13903 , registered in the state of CA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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