Willoughby, Mark Andrew
Willoughby, Mark Andrew is an individual health care provider with primary practice located at 319 F St Ste 102, Chula Vista CA 91910-2666. He recently has only one registered license in Allopathic & Osteopathic Physicians / Dermatology, which is considered as his primary health care specialty. Willoughby, Mark Andrew can be contacted via phone (619) 476-1200.Contact Information
Primary practice address
319 F St Ste 102
Chula Vista CA 91910-2666
Phone: (619) 476-1200
Fax: (619) 420-7849
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Dermatology | 207N00000X | A69750 | California |
Profile Details
| NPI number | 1215931993 |
|---|---|
| LBN Legal business name | Willoughby, Mark Andrew |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jun 9th, 2005 |
| Last updated | Jul 8th, 2007 - about 17 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 | 1215931993 | NPPES |
| California | MEDICAID | 00A697500 |
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