Basic Information
| Provider Information | |||||||||
| NPI: | 1669502894 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | LYTTON WILLIAMS, M.D., PC | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 1007 | ||||||||
| Address2: | |||||||||
| City: | MURRIETA | ||||||||
| State: | CA | ||||||||
| PostalCode: | 925641007 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9516969061 | ||||||||
| FaxNumber: | 9516964602 | ||||||||
| Practice Location | |||||||||
| Address1: | 2200 W 3RD ST | ||||||||
| Address2: | SUITE 120 | ||||||||
| City: | LOS ANGELES | ||||||||
| State: | CA | ||||||||
| PostalCode: | 900571932 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2132075790 | ||||||||
| FaxNumber: | 2132075889 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 03/06/2007 | ||||||||
| LastUpdateDate: | 10/22/2007 | ||||||||
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| AuthorizedOfficialLastName: | WILLIAMS | ||||||||
| AuthorizedOfficialFirstName: | LYTTON | ||||||||
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| AuthorizedOfficialTitleorPosition: | CEO | ||||||||
| AuthorizedOfficialTelephone: | 2132075635 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialCredential: | M.D. | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207XS0117X | G40156 | CA | Y | 193400000X SINGLE SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Orthopaedic Surgery | Orthopaedic Surgery of the Spine |
ID Information
| ID | Type | State | Issuer | Description | G40156 | 01 | CA | LICENSE | OTHER |