| Gregory Willett Md, A Professional Corporation | |
|
4477 W 118th St 400 Hawthorne CA 90250-2255 | |
| (310) 978-0884 | |
| Not Available |
| Full Name | Gregory Willett Md, A Professional Corporation |
|---|---|
| Speciality | Psychiatry & Neurology |
| Location | 4477 W 118th St, Hawthorne, California |
| Authorized Official Name and Position | Thomas Gregory Willett (PRESIDENT) |
| Authorized Official Contact | 3109780884 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Gregory Willett Md, A Professional Corporation 3521 Lomita Blvd Ste 103 Torrance CA 90505-5041 Ph: (310) 534-9131 | Gregory Willett Md, A Professional Corporation 4477 W 118th St 400 Hawthorne CA 90250-2255 Ph: (310) 978-0884 |
| NPI Number | 1881774743 |
|---|---|
| Provider Enumeration Date | 10/16/2006 |
| Last Update Date | 02/22/2008 |
| Medicare PECOS PAC ID | 4789766296 |
|---|---|
| Medicare Enrollment ID | O20080123000402 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1881774743 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2084P0800X | Psychiatry & Neurology - Psychiatry | A22826 (California) | Primary |
| Provider Name | Thomas G Willett |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1740229483 PECOS PAC ID: 2264514777 Enrollment ID: I20080123000385 |
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