Individual
DR. MARK ANDREW WILLOUGHBY
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
319 F ST, STE 102, CHULA VISTA, CA 91910-2666
(619) 476-1200
(619) 420-7849
Mailing address
319 F ST, STE 102, CHULA VISTA, CA 91910-2666
(619) 476-1200
(619) 420-7849
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
A69750
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00A697500
—
CA
Enumeration date
06/09/2005
Last updated
07/08/2007
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