Provider Demographics
NPI:1700670718
Name:WILLIAMS, ZACHARY J (MD, PHD)
Entity type:Individual
Prefix:DR
First Name:ZACHARY
Middle Name:J
Last Name:WILLIAMS
Suffix:
Gender:M
Credentials:MD, PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10833 LECONTE AVENUE BH-239A
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90095-7058
Mailing Address - Country:US
Mailing Address - Phone:805-729-6691
Mailing Address - Fax:
Practice Address - Street 1:10833 LECONTE AVENUE BH-239A
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90095-7058
Practice Address - Country:US
Practice Address - Phone:800-825-9989
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-04-07
Last Update Date:2025-04-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training ProgramGroup - Single Specialty