Active NPI
Darryl Willoughby M.D., Inc
- Orthopaedic Surgery Physician
- Los Angeles, CA
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Orthopaedic Surgery Physician
- License
- A54030
- Legal business name
- DARRYL WILLOUGHBY M.D., INC
- Practice address
- 1414 S Grand Ave
Suite 307
Los Angeles, CA 90015-3067 - Phone
- (213) 765-8088
- Fax
- (310) 329-3239
- NPI assigned
- Apr 1, 2009
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Darryl A Willoughby, MD
- Title
- Sole Proprietor
- Phone
- (310) 968-6012
Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Orthopaedic Surgery Physician | 207X00000X | A54030 | CA | Primary |
Addresses
Primary practice location
1414 S Grand Ave
Suite 307
Los Angeles, CA 90015-3067
Mailing address
PO Box 6620
Torrance, CA 90504-0620
Phone (310) 968-6012
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 00A540300 | Medicaid | CA |
National Provider Directory
National Provider Directory- Tax ID family
- Darryl a Willoughby MD Inc
Other organizations with this tax ID 1
Organizations that report the same tax identification number in the National Provider Directory.
-
- Specialist
- Los Angeles, CA
- NPI 1851559538
Locations
1414 S Grand Ave
Ste 307
Los Angeles, CA 90015
Phone (213) 765-8088
Practitioners & affiliated clinicians
Practitioners 2
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.
-
- Surgery Physician
- Los Angeles, CA
- NPI 1962585570
-
- Orthopaedic Surgery Physician
- Los Angeles, CA
- NPI 1831123934
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1238544000000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1238544000000",
"number": "1770725145",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 6620",
"city": "TORRANCE",
"state": "CA",
"postal_code": "905040620",
"telephone_number": "310-968-6012",
"fax_number": "310-329-3239"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1414 S GRAND AVE",
"address_2": "SUITE 307",
"city": "LOS ANGELES",
"state": "CA",
"postal_code": "900153067",
"telephone_number": "213-765-8088",
"fax_number": "310-329-3239"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "DARRYL WILLOUGHBY M.D., INC",
"organizational_subpart": "NO",
"enumeration_date": "2009-04-01",
"last_updated": "2009-04-01",
"status": "A",
"authorized_official_last_name": "WILLOUGHBY",
"authorized_official_first_name": "DARRYL",
"authorized_official_middle_name": "A",
"authorized_official_title_or_position": "SOLE PROPRIETOR",
"authorized_official_telephone_number": "310-968-6012",
"authorized_official_credential": "MD"
},
"taxonomies": [
{
"code": "207X00000X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Orthopaedic Surgery",
"state": "CA",
"license": "A54030",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "00A540300",
"state": "CA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Los Angeles, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 1, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.