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Individual

DARRYL ALAN WILLOUGHBY

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
1513 S GRAND AVE # 208, LOS ANGELES, CA 90015-3021
(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
208600000X
Surgery Physician
Primary
A54030
CA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
00A540300
CA
Enumeration date
10/24/2006
Last updated
06/01/2010
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