Organization
DARRYL WILLOUGHBY M.D., INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DARRYL A WILLOUGHBY MD (SOLE PROPRIETOR)
(310) 968-6012
Entity
Organization
Contact information
Practice address
1414 S GRAND AVE, SUITE 307, LOS ANGELES, CA 90015-3067
(213) 765-8088
(310) 329-3239
Mailing address
PO BOX 6620, TORRANCE, CA 90504-0620
(310) 968-6012
(310) 329-3239
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
A54030
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00A540300
—
CA
Enumeration date
04/01/2009
Last updated
04/01/2009
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