Individual
AUSTIN JOE WILLIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
1310 CLUB DR, VALLEJO, CA 94592-1187
(707) 638-5809
Mailing address
3476 S LELAND ST, SAN PEDRO, CA 90731-6126
(310) 922-4637
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
—
—
Other
Enumeration date
05/16/2021
Last updated
05/16/2021
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