Provider Demographics
NPI:1508026246
Name:THOMAS G WILLIAMS, MD INC
Entity Type:Organization
Organization Name:THOMAS G WILLIAMS, MD INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:THOMAS
Authorized Official - Middle Name:G
Authorized Official - Last Name:WILLIAMS
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:949-588-2190
Mailing Address - Street 1:25470 MEDICAL CENTER DR
Mailing Address - Street 2:SUITE 206
Mailing Address - City:MURRIETA
Mailing Address - State:CA
Mailing Address - Zip Code:92562-4900
Mailing Address - Country:US
Mailing Address - Phone:949-588-2190
Mailing Address - Fax:951-973-7389
Practice Address - Street 1:25495 MEDICAL CENTER DR
Practice Address - Street 2:SUITE 101
Practice Address - City:MURRIETA
Practice Address - State:CA
Practice Address - Zip Code:92562-5963
Practice Address - Country:US
Practice Address - Phone:949-588-2190
Practice Address - Fax:951-973-7389
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-06-16
Last Update Date:2021-07-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG68083207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAE38559Medicare UPIN