Individual
DR. WILLARD S ELLIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
2315 STOCKTON BLVD, MAIN HOSPITAL, SACRAMENTO, CA 95817-2201
(916) 734-7506
(916) 734-4810
Mailing address
4150 V ST, SUITE 3400 UCD SCHOOL OF MEDICINE, SACRAMENTO, CA 95817-1460
(916) 734-7506
(916) 734-4810
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
A73530
CA
208M00000X
Hospitalist Physician
Primary
A73530
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
A735300
—
CA
Enumeration date
01/06/2006
Last updated
12/09/2021
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