NPIMap

Matthew Clifford Willett, M.D.

Individual provider Active NPI Dermatology Physician · Camp Pendleton, CA

NPI 1720328107 · NPPES record last updated Feb 22, 2024

Key facts

NPI
1720328107
Entity type
Individual (NPI type 1)
Primary specialty
Dermatology Physician 207N00000X
License
132174 (CA)
Practice address
Naval Hospital Camp Pendleton
200 Mercy Circle
Camp Pendleton, CA 92055-5191
Phone
(760) 719-3249
NPI assigned
Feb 22, 2013
Sex
Male
Sole proprietor
Yes

Organizations & group practices 26

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

View all 26

Medicare Care Compare profile

Specialty
Dermatology
Education
Other, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Scripps Health (1,450 clinicians)
Pacific Dermatology Institute (32 clinicians)

Practice addresses (Care Compare)

10820 N Torrey Pines Rd
La Jolla, CA 92037-1036
Phone (858) 554-4100

25405 Hancock Ave
Suite 200
Murrieta, CA 92562-5978
Phone (951) 200-2090

Procedures performed for Medicare patients

ProcedureNumber of procedures
Melanoma (skin cancer) excision12
Removal of skin lesions64
Removal of skin cancer231
Removal or shaving of skin growth1-10
Skin biopsy24

Medicare participation

Medicare fee-for-service enrollment
Enrolled (3 enrollments) in CA, NM, PA
Eligible to order & refer
Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
I20230609002552 CA Practitioner - Dermatology 8426383480 Reassigns benefits to 5 organizations
I20250422000909 NM Practitioner - Dermatology 8426383480 Reassigns benefits to 1 organization
I20250527001873 PA Practitioner - Micrographic Dermatologic Surgery (MDS) 8426383480 Reassigns benefits to 1 organization

National Provider Directory

Medicare enrollment (NPD)
Yes
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
132174CAMDDermatology Physician

Practice roles (15 of 16)

OrganizationSpecialtyStatusNew patients
K. D. Macknet, M.D., Inc. Dermatology Current Accepting new patients
St. Luke'S Physician Group, Inc. Current
since Jun 26, 2025		 Accepting new patients
St. Luke'S Physician Group, Inc. Current Accepting new patients
Advanced Dermatology & Cosmetics Laser Care a Medical Corporation Dermatology Current
since Oct 4, 2023		 Accepting new patients
Scripps Health Dermatology Current
since Oct 2, 2023		 Accepting new patients
Scripps Health Current
since Oct 2, 2023		 Accepting new patients
Pacific Dermatology Institute Dermatology Current
since Jun 1, 2024		 Accepting new patients
Csi Medical Group Dermatology Current
since May 15, 2024		 Accepting new patients
Willett Medical Group Dermatology Current Accepting new patients
Timothy F. Richardson, M.D., a Medical Corporation Current Accepting new patients
St Luke'S Physician Group Inc Current
since Jun 26, 2025		 Accepting new patients
David C Leech DO Inc PC Current
since Feb 15, 2025		 Accepting new patients
United States Navy Past Accepting new patients
Scripps Clinic Medical Group Past Accepting new patients
Southcoast Physicians Group, Inc. Past
since Jul 15, 2019		 Accepting new patients

Locations (25 of 29)

18523 Corwin Rd
Ste G
Apple Valley, CA 92307
Phone (760) 242-3376

4100 Empire Dr
Ste 120
Bakersfield, CA 93309
Phone (661) 254-3686

1620 E Second St
Ste N
Beaumont, CA 92223
Phone (951) 845-6500

835 Highland Springs Ave
Ste 105
Beaumont, CA 92223
Phone (951) 875-6412

770 Magnolia Ave
Ste 1H
Corona, CA 92879
Phone (951) 549-9696

12442 Limonite Ave
Unit 202
Eastvale, CA 91752
Phone (951) 734-6500

16465 Sierra Lakes Pkwy
Ste 275
Fontana, CA 92336
Phone (909) 279-1010

9888 Genesee Ave
La Jolla, CA 92037
Phone (858) 457-4123

10820 N Torrey Pines Rd
La Jolla, CA 92037
Phone (858) 554-3300

25815 Barton Rd
Ste 101
Loma Linda, CA 92354
Phone (909) 796-0224

File 54433
Los Angeles, CA 90074
Phone (858) 784-5645

525 South Dr
Ste 115
Mountain View, CA 94040
Phone (408) 369-5600

25405 Hancock Ave
Ste 200
Murrieta, CA 92562
Phone (909) 698-7720

74090 El Paseo
Ste 103
Palm Desert, CA 92260
Phone (760) 341-8244

36867 Cook St
Ste 101
Palm Desert, CA 92211
Phone (760) 341-1999

1801 E Tahquitz Canyon Way
Ste 103
Palm Springs, CA 92262
Phone (760) 537-5561

19709 Rinaldi St
Ste 101D
Porter Ranch, CA 91326

255 Terracina Blvd
Ste 205C
Redlands, CA 92373
Phone (909) 793-2323

1481 Ford St
Ste 102
Redlands, CA 92373
Phone (909) 793-2323

1200 California St
Ste 210
Redlands, CA 92374
Phone (909) 693-3424

9041 Magnolia Ave
Ste 206
Riverside, CA 92503
Phone (951) 354-0676

18988 Cox Ave
Ste B
Saratoga, CA 95070
Phone (408) 253-4407

1666 N Waterman Ave
Sn Bernrdno, CA 92404
Phone (888) 700-0881

585 N Mountain Ave
Ste A
Upland, CA 91786
Phone (909) 608-7546

28212 Kelly Johnson Pkwy
Ste 245
Valencia, CA 91355
Phone (661) 254-3686

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/17606/brand/1/csg/1/fhir/r4
  • Direct secure messaging: mwillett346213@direct-sluhn.org

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
MOHS-Micrographic Surgery Physician 207ND0101X 132174 CA
Dermatology Physician 207N00000X 132174 CA Yes

Addresses

Primary practice location

Naval Hospital Camp Pendleton
200 Mercy Circle
Camp Pendleton, CA 92055-5191

Mailing address

PO Box 555191
Camp Pendleton, CA 92055-5191
Phone (760) 719-3249

Other practice location 1

10820 N Torrey Pines Rd
LA Jolla, CA 92037-1036
Phone (858) 554-8646

Other practice location 2

36867 Cook St Ste 101
Palm Desert, CA 92211-6064
Phone (760) 341-1999

Other providers in Camp Pendleton, CA

All providers in Camp Pendleton, CA · Dermatology Physician in California

Sources for this page

Verify at the official NPI Registry.