Provider Demographics
NPI:1588761001
Name:WILLIAMS, JULIO E (MD)
Entity type:Individual
Prefix:
First Name:JULIO
Middle Name:E
Last Name:WILLIAMS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3400 DATA DR
Mailing Address - Street 2:
Mailing Address - City:RANCHO CORDOVA
Mailing Address - State:CA
Mailing Address - Zip Code:95670-7956
Mailing Address - Country:US
Mailing Address - Phone:916-851-2462
Mailing Address - Fax:
Practice Address - Street 1:401 E HIGHLAND AVE STE 251
Practice Address - Street 2:
Practice Address - City:SAN BERNARDINO
Practice Address - State:CA
Practice Address - Zip Code:92404-3800
Practice Address - Country:US
Practice Address - Phone:909-882-4605
Practice Address - Fax:909-475-2680
Is Sole Proprietor?:No
Enumeration Date:2006-09-19
Last Update Date:2024-09-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAC171431208G00000X
TXK6740208600000X, 208G00000X
NY332354208G00000X
WAMD60216935208G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208G00000XAllopathic & Osteopathic PhysiciansThoracic Surgery (Cardiothoracic Vascular Surgery)
No208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX8X2170OtherBLUE CROSS
TX096712701Medicaid
TXG79673Medicare UPIN
TX8J1364Medicare PIN
TXP00414210Medicare PIN