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Individual

DANIEL LAMAR WILLIS

Active
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Individual

DANIEL LAMAR WILLIS

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
M.D.

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
A102873
CA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
—
FHC70936F
—
CA
01
—
W1508
CHCCC, NIPOMO MEDICAL CENTER NPI# 1841217866 GROUP PTAN
CA
01
—
W1508A
CHCCC, TEMPLETON NPI# 1275550295 GROUP PTAN#
CA
01
—
W1508E
SAN LUIS OBISPO- PTAN GROUP# NPI# 1275550295
CA
Enumeration date
03/20/2008
Last updated
06/15/2015
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