Willis, Adelaide

Willis, Adelaide is an individual health care provider with primary practice located at 1500 W West Covina Pkwy , West Covina CA 91790-2708. She recently has only one registered license in Allopathic & Osteopathic Physicians / Family Medicine, which is considered as her primary health care specialty. Willis, Adelaide can be contacted via phone (626) 960-8614.

Contact Information

Primary practice address
1500 W West Covina Pkwy West Covina CA 91790-2708
Phone: (626) 960-8614
Fax: (626) 960-8624
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X A44131 California

Profile Details

NPI number 1073561346
LBN Legal business name Willis, Adelaide
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date May 5th, 2006
Last updated Apr 28th, 2011 - about 15 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1073561346 NPPES
California MEDICAID 00A441310

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