Individual
MS. IMANI WILLIAMS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
12021 WILMINGTON AVE, LOS ANGELES, CA 90059-3019
(310) 668-4515
(310) 763-8909
Mailing address
4381 MAURY AVE, LONG BEACH, CA 90807-2536
Taxonomy
Speciality
Code
Description
License number
State
363AS0400X
Surgical Physician Assistant
Primary
PA11638
CA
Other
Enumeration date
02/27/2007
Last updated
07/08/2007
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