Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207XS0117X | Orthopaedic Spine Surgeon | G40156 | CA |
NPI | 1235277195 |
---|---|
Provider Name | Lytton A Williams |
First Address | Los Angeles, CA 90057-1932 |
Second Address | Los Angeles, CA 90057-1932 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 02/02/2007 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
A48112 | (02) | CA |
W14159 | (05) | CA |