Provider Demographics
NPI:1811942204
Name:TOBIN-WILLIAMS, ALICIA ANDREA (MD)
Entity type:Individual
Prefix:
First Name:ALICIA
Middle Name:ANDREA
Last Name:TOBIN-WILLIAMS
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:ALICIA
Other - Middle Name:ANDREA
Other - Last Name:TOBIN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 45680
Mailing Address - Street 2:
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94145-0680
Mailing Address - Country:US
Mailing Address - Phone:530-672-7060
Mailing Address - Fax:530-672-7061
Practice Address - Street 1:3501 PALMER DR
Practice Address - Street 2:SUITE 204
Practice Address - City:CAMERON PARK
Practice Address - State:CA
Practice Address - Zip Code:95682-8276
Practice Address - Country:US
Practice Address - Phone:530-672-7040
Practice Address - Fax:530-672-7061
Is Sole Proprietor?:No
Enumeration Date:2006-05-23
Last Update Date:2016-01-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA92932207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
I49680Medicare UPIN
00A929320Medicare ID - Type Unspecified