Ellis, Willard S
Ellis, Willard S is an individual health care provider with primary practice located at 2315 Stockton Blvd Main Hospital, Sacramento CA 95817-2201. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Internal Medicine, Allopathic & Osteopathic Physicians / Hospitalist. Allopathic & Osteopathic Physicians / Hospitalist is his primary health care specialty. Ellis, Willard S can be contacted via phone (916) 734-7506.Contact Information
Primary practice address
2315 Stockton Blvd Main Hospital
Sacramento CA 95817-2201
Phone: (916) 734-7506
Fax: (916) 734-4810
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Internal Medicine | 207R00000X | A73530 | California |
| Allopathic & Osteopathic Physicians / Hospitalist | 208M00000X | A73530 | California |
Profile Details
| NPI number | 1306824503 |
|---|---|
| LBN Legal business name | Ellis, Willard S |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jan 6th, 2006 |
| Last updated | Dec 9th, 2021 - about 4 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1306824503 | NPPES |
| California | MEDICAID | A735300 |
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