Organization
LAURA WILLIAMS MD
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. LAURA A WILLIAMS MD, MPH (OWNER)
(951) 696-4009
Entity
Organization
Contact information
Practice address
25102 JEFFERSON AVE, SUITE A, MURRIETA, CA 92562-1707
(951) 696-4009
(951) 696-8448
Mailing address
25102 JEFFERSON AVE, SUITE A, MURRIETA, CA 92562-1707
(951) 696-4009
(951) 696-8448
Taxonomy
Speciality
Code
Description
License number
State
261QP2300X
Primary Care Clinic/Center
Primary
G76077
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00G76077
—
CA
01
—
05D1051900
CLIA ID #
CA
01
—
10977784
CAQH #
CA
01
—
1861482531
NPI INDIVIDUAL #
CA
01
—
G76077
MEDICAL LICENSE #
CA
Enumeration date
09/27/2006
Last updated
03/07/2023
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