Individual
MR. JEFFREY ALLEN WILLIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
RN
Contact information
Practice address
555 E HARDY ST, INGLEWOOD, CA 90301-4011
(310) 419-8628
(310) 412-4504
Mailing address
14333 WHITEROCK DR, LA MIRADA, CA 90638-3831
(310) 419-8628
(310) 412-4504
Taxonomy
Speciality
Code
Description
License number
State
163WA2000X
Administrator Registered Nurse
Primary
95061769
CA
Other
Enumeration date
02/06/2026
Last updated
02/06/2026
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