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:
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Health care specialties

SpecialtyCodeLicense #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 3 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1306824503 NPPES
California MEDICAID A735300

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