Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207P00000X | Emergency Physician | G32937 | CA |
N | 208000000X | Pediatrician | G32937 | CA |
N | 208D00000X | General Practice Physician | G32937 | CA |
NPI | 1023168721 |
---|---|
Provider Name | Timothy Lee Williamson |
First Address | Ojai, CA 93023-3119 |
Second Address | Ojai, CA 93023-3119 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 12/01/2007 |
Last Update Date | 13/05/2020 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
00G329370 | (05) | CA |
A91486 | (02) | CA |