Individual provider · Type 1 NPI

Edie Willis, PA-C

Medical Physician Assistant · Los Angeles, CA

NPI number 1356877328 Active

Practice location

1520 San Pablo St Ste 1000
Los Angeles, CA 90033-5312

Call (323) 442-5100 Map

Mailing address

PO Box 31309
Los Angeles, CA 90031-0309

Specialties and licenses

TaxonomyCodeLicense
Medical Physician Assistant 363AM0700X008351 (GA)
Medical Physician Assistant Primary 363AM0700XPA62067 (CA)

Medical Physician Assistant: Definition to come...

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About NPI 1356877328

Edie Willis, PA-C's National Provider Identifier is 1356877328, issued on May 11, 2017. The primary taxonomy on file is Medical Physician Assistant (363AM0700X), and the practice location is in Los Angeles, CA. The record was last updated on Mar 14, 2023.