Individual
DR. ADELAIDE WILLIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
1500 W WEST COVINA PKWY, WEST COVINA, CA 91790-2708
(626) 960-8614
(626) 960-8624
Mailing address
1500 W WEST COVINA PKWY, WEST COVINA, CA 91790-2708
(626) 960-8614
(626) 960-8624
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
A44131
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00A441310
—
CA
Enumeration date
05/05/2006
Last updated
04/28/2011
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