Center for Lifestyle Health a Professional Corporation

Primary specialty

Public Health & General Preventive Medicine PhysicianTaxonomy code 2083P0901X

License

A65963 Issued in CA

Legal business name

CENTER FOR LIFESTYLE HEALTH A PROFESSIONAL CORPORATION

Practice address

2079 Compton Ave BLDG 3a
Suite 102
Corona, CA 92881-7284

Phone

(951) 496-4281

Fax

(951) 496-4222

NPI assigned

Aug 19, 2016

Last updated

Sep 16, 2016By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Dave A Williams, MD

Title

President/Provider

Phone

(951) 496-4281

Specialties & licenses 1

Addresses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1471564800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1473984000000",
    "number": "1073068029",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2079 COMPTON AVE BLDG 3A",
            "address_2": "SUITE 102",
            "city": "CORONA",
            "state": "CA",
            "postal_code": "928817284",
            "telephone_number": "951-496-4281"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2079 COMPTON AVE BLDG 3A",
            "address_2": "SUITE 102",
            "city": "CORONA",
            "state": "CA",
            "postal_code": "928817284",
            "telephone_number": "951-496-4281",
            "fax_number": "951-496-4222"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CENTER FOR LIFESTYLE HEALTH A PROFESSIONAL CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-08-19",
        "last_updated": "2016-09-16",
        "status": "A",
        "authorized_official_last_name": "WILLIAMS",
        "authorized_official_first_name": "DAVE",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "PRESIDENT/PROVIDER",
        "authorized_official_telephone_number": "951-496-4281",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "2083P0901X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Preventive Medicine, Public Health & General Preventive Medicine",
            "state": "CA",
            "license": "A65963",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Public Health & General Preventive Medicine Physician in Corona, CA
• Providers in Corona, CA by specialty
• Public Health & General Preventive Medicine Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 16, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.