Provider Demographics
NPI:1033475751
Name:ALAN E WILLIAMSON MD INC
Entity Type:Organization
Organization Name:ALAN E WILLIAMSON MD INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:ALAN
Authorized Official - Middle Name:E
Authorized Official - Last Name:WILLIAMSON
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:760-341-7088
Mailing Address - Street 1:39300 BOB HOPE DR
Mailing Address - Street 2:BANNAN BUILDING, SUITE 1101
Mailing Address - City:RANCHO MIRAGE
Mailing Address - State:CA
Mailing Address - Zip Code:92270-3203
Mailing Address - Country:US
Mailing Address - Phone:760-341-7088
Mailing Address - Fax:760-773-0596
Practice Address - Street 1:39300 BOB HOPE DR
Practice Address - Street 2:BANNAN BUILDING, SUITE 1101
Practice Address - City:RANCHO MIRAGE
Practice Address - State:CA
Practice Address - Zip Code:92270-3203
Practice Address - Country:US
Practice Address - Phone:760-341-7088
Practice Address - Fax:760-773-0596
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-04-06
Last Update Date:2012-04-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2086S0129XAllopathic & Osteopathic PhysiciansSurgeryVascular SurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAE98927Medicare UPIN