Individual
DANIEL LAMAR WILLIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
325 POSADA LN, A-C, TEMPLETON, CA 93465-4003
(805) 542-6700
(805) 549-0465
Mailing address
2050 S BLOSSER RD, SANTA MARIA, CA 93458-7310
(805) 361-8028
(805) 361-8097
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
A102873
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
FHC70936F
—
CA
01
—
W1508
CHCCC, NIPOMO MEDICAL CENTER NPI# 1841217866 GROUP PTAN
CA
01
—
W1508A
CHCCC, TEMPLETON NPI# 1275550295 GROUP PTAN#
CA
01
—
W1508E
SAN LUIS OBISPO- PTAN GROUP# NPI# 1275550295
CA
Enumeration date
03/20/2008
Last updated
06/15/2015
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