Provider Demographics
NPI:1053027516
Name:TRILLIUM INC
Entity type:Organization
Organization Name:TRILLIUM INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEDICAL DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:TROY
Authorized Official - Middle Name:
Authorized Official - Last Name:WILLIAMS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:805-217-4055
Mailing Address - Street 1:4607 LAKEVIEW CANYON RD # 565
Mailing Address - Street 2:
Mailing Address - City:WESTLAKE VILLAGE
Mailing Address - State:CA
Mailing Address - Zip Code:91361-4028
Mailing Address - Country:US
Mailing Address - Phone:805-217-4055
Mailing Address - Fax:818-597-9328
Practice Address - Street 1:1240 S WESTLAKE BLVD STE 137
Practice Address - Street 2:
Practice Address - City:WESTLAKE VILLAGE
Practice Address - State:CA
Practice Address - Zip Code:91361-1988
Practice Address - Country:US
Practice Address - Phone:818-597-9320
Practice Address - Fax:818-597-9328
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-01-27
Last Update Date:2023-01-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGroup - Single Specialty