Provider Demographics
NPI:1528075389
Name:WILLIAMS, ANDREW SYDNEY (MD)
Entity type:Individual
Prefix:
First Name:ANDREW
Middle Name:SYDNEY
Last Name:WILLIAMS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:101 S SAN MATEO DR
Mailing Address - Street 2:STE 306
Mailing Address - City:SAN MATEO
Mailing Address - State:CA
Mailing Address - Zip Code:94401-3844
Mailing Address - Country:US
Mailing Address - Phone:415-431-9555
Mailing Address - Fax:
Practice Address - Street 1:101 S SAN MATEO DR
Practice Address - Street 2:STE 306
Practice Address - City:SAN MATEO
Practice Address - State:CA
Practice Address - Zip Code:94401-3844
Practice Address - Country:US
Practice Address - Phone:650-696-7070
Practice Address - Fax:650-348-1314
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-02
Last Update Date:2019-03-07
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CAG56863207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
00G568631Medicare ID - Type UnspecifiedPPIN
B75077Medicare UPIN