Willis, Mary Jane Hall
Willis, Mary Jane Hall is an individual health care provider with primary practice located at 34520 Bob Wilson Dr Suite 100, San Diego CA 92134-2098. She recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Clinical Genetics (M.D.), Allopathic & Osteopathic Physicians / Pediatrics. Allopathic & Osteopathic Physicians / Pediatrics is her primary health care specialty. Willis, Mary Jane Hall can be contacted via phone (619) 532-6896.Contact Information
Primary practice address
34520 Bob Wilson Dr Suite 100
San Diego CA 92134-2098
Phone: (619) 532-6896
Fax: (619) 532-9184
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Clinical Genetics (M.D.) | 207SG0201X | A75301 | California |
| Allopathic & Osteopathic Physicians / Pediatrics | 208000000X | A75301 | California |
Profile Details
| NPI number | 1104998053 |
|---|---|
| LBN Legal business name | Willis, Mary Jane Hall |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Nov 15th, 2006 |
| Last updated | Mar 3rd, 2023 - about 3 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1104998053 | NPPES |
| California | MEDICAID | 00A753010 |
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