Provider Demographics
NPI:1568540417
Name:WILLIAMS, ERIK JAN (MD)
Entity Type:Individual
Prefix:DR
First Name:ERIK
Middle Name:JAN
Last Name:WILLIAMS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:36921 COOK ST
Mailing Address - Street 2:SUITE #103
Mailing Address - City:PALM DESERT
Mailing Address - State:CA
Mailing Address - Zip Code:92211-6070
Mailing Address - Country:US
Mailing Address - Phone:760-568-3111
Mailing Address - Fax:760-836-1151
Practice Address - Street 1:36921 COOK ST
Practice Address - Street 2:SUITE #103
Practice Address - City:PALM DESERT
Practice Address - State:CA
Practice Address - Zip Code:92211-6070
Practice Address - Country:US
Practice Address - Phone:760-568-3111
Practice Address - Fax:760-836-1151
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-01
Last Update Date:2008-06-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA23475207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
A23665Medicare UPIN
CA00A237450Medicare ID - Type Unspecified