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Individual

DR. DOUGLAS ROBERT WILLARD

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
M.D,

Contact information

Practice address
100 W CALIFORNIA BLVD, PASADENA, CA 91105-3010
(626) 397-3445
(626) 397-5643
Mailing address
PO BOX 60259, LOS ANGELES, CA 90060-0259
(626) 447-0296
(626) 447-6057

Taxonomy

Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
G45938
CA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
00G459380
CA
Enumeration date
08/23/2006
Last updated
06/05/2008
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