Provider Demographics
NPI:1366499709
Name:WILLIAMS, LOUIS J (DC)
Entity Type:Individual
Prefix:DR
First Name:LOUIS
Middle Name:J
Last Name:WILLIAMS
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:29645 RANCHO CALIFORNIA RD STE 218
Mailing Address - Street 2:
Mailing Address - City:TEMECULA
Mailing Address - State:CA
Mailing Address - Zip Code:92591-5285
Mailing Address - Country:US
Mailing Address - Phone:951-676-4080
Mailing Address - Fax:951-676-9086
Practice Address - Street 1:29645 RANCHO CALIFORNIA RD STE 218
Practice Address - Street 2:
Practice Address - City:TEMECULA
Practice Address - State:CA
Practice Address - Zip Code:92591-5285
Practice Address - Country:US
Practice Address - Phone:951-676-4080
Practice Address - Fax:951-676-9086
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-30
Last Update Date:2019-08-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CADC25999111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAZZZ04140ZOtherMEDICARE GROUP
CADC0259990OtherBLUE SHIELD
CADC0259990OtherBLUE SHIELD
CADC0259990Medicare PIN