Provider Demographics
NPI:1144245838
Name:WILLIAMS, RAY EVERETT (MD)
Entity Type:Individual
Prefix:DR
First Name:RAY
Middle Name:EVERETT
Last Name:WILLIAMS
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:323 N PRAIRIE AVE
Mailing Address - Street 2:SUITE 222
Mailing Address - City:INGLEWOOD
Mailing Address - State:CA
Mailing Address - Zip Code:90301-4502
Mailing Address - Country:US
Mailing Address - Phone:310-674-2876
Mailing Address - Fax:310-674-1827
Practice Address - Street 1:323 N PRAIRIE AVE
Practice Address - Street 2:SUITE 222
Practice Address - City:INGLEWOOD
Practice Address - State:CA
Practice Address - Zip Code:90301-4502
Practice Address - Country:US
Practice Address - Phone:310-674-2876
Practice Address - Fax:310-674-1827
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-13
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CAG32137207RA0201X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RA0201XAllopathic & Osteopathic PhysiciansInternal MedicineAllergy & Immunology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00G321370Medicaid
CAA91406Medicare UPIN
CAG32137Medicare ID - Type Unspecified