Willow Medical Group

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

DC 20570 Issued in CA

Legal business name

WILLOW MEDICAL GROUP

Practice address

3311 E Willow St
Long Beach, CA 90806

Phone

(562) 424-4976

Fax

(562) 424-5960

NPI assigned

Jun 23, 2006

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Lawrence J Domaracki

Title

Co-Owner DC

Phone

(562) 424-4976

Specialties & licenses 3

Addresses

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1151020800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1199404800000",
    "number": "1013943000",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3311 E WILLOW ST",
            "city": "LONG BEACH",
            "state": "CA",
            "postal_code": "90806",
            "telephone_number": "562-424-4976",
            "fax_number": "562-424-5960"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3311 E WILLOW ST",
            "city": "LONG BEACH",
            "state": "CA",
            "postal_code": "90806",
            "telephone_number": "562-424-4976",
            "fax_number": "562-424-5960"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WILLOW MEDICAL GROUP",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-23",
        "last_updated": "2008-01-04",
        "status": "A",
        "authorized_official_last_name": "DOMARACKI",
        "authorized_official_first_name": "LAWRENCE",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "CO-OWNER DC",
        "authorized_official_telephone_number": "562-424-4976"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Chiropractor",
            "state": "CA",
            "license": "DC 20570",
            "primary": true
        },
        {
            "code": "207LP2900X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Anesthesiology, Pain Medicine",
            "state": "CA",
            "license": "G59739",
            "primary": false
        },
        {
            "code": "207XS0117X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Orthopaedic Surgery, Orthopaedic Surgery of the Spine",
            "state": "CA",
            "license": "A38436",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Willing 2 Move Forward
• Angela Lynn Willis
• Jean Marie Willis, LCSW
• Monique Elexandra Willis, MS
• Ayal Willner, MD
• Willow Medical Group
• Erica Jaquai Wills
• Michael Patrick Alvin Wills
• Monica Willson, MFT TRAINEE
• Natalia Wilson Bey

• Chiropractor in Long Beach, CA
• Providers in Long Beach, CA by specialty
• Chiropractor in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 4, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.