Look up the most recent NPI and PECOS records

Jared Williams

Family Medicine

Allopathic & Osteopathic Physicians

660 Baker St Ste A101, Costa Mesa, CA 92626-4407

PECOS Enrollment

Based on the most recent information from CMS, provider Jared Williams is legally eligible to order and refer claims for Part B, HHA, DME and PMD services.

Part B
Medicare Part B
Enrolled
HHA
Home Health Agency
Enrolled
DME
Durable Medical Equipment
Enrolled
PMD
Power Mobility Device
Enrolled

CMS last updated its PECOS records 4 days ago.

Profile Details

Provider ID
1568401057
Provider Type
Individual
Full Name
Williams, Jared
Title
Dr.
Credential
MD

Gender
Male
Sole Proprietor
No
Enumeration Date
6/6/2006
Last Updated
8/3/2023

Contact Information

Practice Location

660 Baker St Ste A101, Costa Mesa, CA 92626-4407

(714) 668-2500

(714) 668-2515

Mailing Location

PO Box 2218, Suisun City, CA 94585-5218

(657) 241-3600

(657) 241-7708

Provider Taxonomies

Code	Description	License
Code 207Q00000X Primary	Description Family Medicine Allopathic & Osteopathic Physicians	License A77371 California
Code 207QS0010X	Description Family Medicine Allopathic & Osteopathic Physicians	License A77371 California

Jared Williams

PECOS Enrollment

Profile Details

Contact Information

Practice Location

Mailing Location

Provider Taxonomies

Code

Description

License

Code

Description

License

Code

Description

License

Careconnectmd Ca Pc

Doan, Loi

Nguyen, Mandy

Nguyen, Gina-Nga T

Do, Hau

Gupta, Monica

Gottschalk, Guy H

Bristol Park Medical Group, Inc

Le, Hung Van

Shaw, Pravin