DR. DOUGLAS ROBERT WILLARD (NPI# 1366559874) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1366559874 |
| Entity Type | Individual |
| Full Name | DR. DOUGLAS ROBERT WILLARD |
| Credential | M.D, |
| Practice Address |
100 W California Blvd Pasadena CA 91105-3010 |
| Mailing Address |
Po Box 60259 Los Angeles CA 90060-0259 |
| Practice Telephone | 6263973445 |
| Practice Fax Number | 6263975643 |
| Mailing Telephone | 6264470296 |
| Mailing Fax Number | 6264476057 |
| Enumeration Date | 2006-08-23 |
| Last Update Date | 2008-06-05 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207P00000X | Emergency Medicine | G45938 | CA | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| CA | 00G459380 | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1184618035 | Douglas Frank Willard | Ophthalmology | 207 Madison Ave, Elmira, NY 14901-3204 | 2005-09-07 |
| Street Address |
100 W CALIFORNIA BLVD |
| City | PASADENA |
| State | CA |
| Zip Code | 91105-3010 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1023019460 | David Michael Ulick | Emergency Medicine | 100 W California Blvd, Department of Emergency Medicine, Pasadena, CA 91109 | 2005-08-09 |
| 1477150381 | Julia Yehudit Grinblat | Registered Nurse | 100 W California Blvd, Pasadena, CA 91105-3010 | 2020-10-04 |
| 1487262846 | Sharon Marie Sullivan | Licensed Psychiatric Technician | 100 W California Blvd, Pasadena, CA 91105-3010 | 2020-07-21 |
| 1073121786 | Chelsea Marie Lam | Student in an Organized Health Care Education/Training Program | 100 W California Blvd, Pasadena, CA 91105-3010 | 2020-07-20 |
| 1629696182 | Claudette Bradley | Registered Nurse | 100 W California Blvd, Pasadena, CA 91105-3010 | 2020-07-10 |
| 1962020420 | Rachona Meza | Registered Nurse | 100 W California Blvd, Pasadena, CA 91105-3010 | 2020-07-10 |
| 1417573031 | Carolyn Krystal Kim | Student in an Organized Health Care Education/Training Program | 100 W California Blvd, Pasadena, CA 91105-3010 | 2020-06-19 |
| 1952927584 | Jessica Hsueh | Student in an Organized Health Care Education/Training Program | 100 W California Blvd, Pasadena, CA 91105-3010 | 2020-06-19 |
| 1396361929 | Raissa I Chua | Student in an Organized Health Care Education/Training Program | 100 W California Blvd, Pasadena, CA 91105-3010 | 2020-06-19 |
| 1073139630 | Khoa Nguyen | Student in an Organized Health Care Education/Training Program | 100 W California Blvd, Pasadena, CA 91105-3010 | 2020-06-19 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1619451697 | Tonya Michlin | Registered Nurse | 800 Fairmount Ave Ste 110, Pasadena, CA 91105 | 2018-09-17 |
| 1639674161 | David Marcus Md, Inc. | Psychiatry & Neurology | 107 S. Fair Oaks Avenue, Suite #315, Pasadena, CA 91105 | 2018-03-27 |
| 1548778541 | Elias & Jun Dental Corp | Dentist | 301 S. Fair Oaks Ave., Ste 107, Pasadena, CA 91105 | 2018-01-12 |
| 1013429745 | Whitney Catalano | Dietitian, Registered | 100 S Orange Grove Blvd, 103, Pasadena, CA 91105 | 2017-11-03 |
| 1518485630 | Marlon O Miller | Counselor | 1020 South Arroyo Parkway, Pasadena, CA 91105 | 2017-09-08 |
| 1316469976 | Alexandra Scott | Speech-Language Pathologist | 235 La Vereda Road, Pasadena, CA 91105 | 2017-07-14 |
| 1346770443 | Amanda Grace Gentz | Rehabilitation Practitioner | 210 S De Lacey, Ste 110, Pasadena, CA 91105 | 2017-06-13 |
| 1427598390 | Melina Gomez Loza | Licensed Vocational Nurse | 66 Hilburt St #2, Pasadena, CA 91105 | 2017-02-27 |
| 1588115281 | Ramon Banuelos | Rehabilitation Practitioner | 210 S. Delacey Ave Suite 110, Pasadena, CA 91105 | 2016-10-18 |
| 1922554245 | Daniel Joseph Ybarra | Student in an Organized Health Care Education/Training Program | 100 W. California Blvd. Pasadena, Ca 91105, Pasadena, CA 91105 | 2016-08-28 |
| Find all providers in zip 91105 | ||||
| Taxonomy Code | 207P00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Emergency Medicine |
| An emergency physician focuses on the immediate decision making and action necessary to prevent death or any further disability both in the pre-hospital setting by directing emergency medical technicians and in the emergency department. The emergency physician provides immediate recognition, evaluation, care, stabilization and disposition of a generally diversified population of adult and pediatric patients in response to acute illness and injury. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source; 7/1/2011: mofified source] - Additional Resources: American Board of Emergency Medicine, 2007. http://www.abem.org/public/; American Osteopathic Board of Emergency Medicine, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Emergency Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Emergency Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1841704848 | Medexpress Urgent Care Texas, P.a. | Emergency Medicine | 4750 Fairmont Pkwy, Pasadena, TX 77504-3330 | 2017-11-29 |
| 1578829438 | Kevin W Chu | Emergency Medicine | 100 West California Blvd, Unit 25, Pasadena, CA 91105 | 2012-04-05 |
| 1528367174 | Huma Khan | Emergency Medicine | 2079 Monte Vista St, Pasadena, CA 91107 | 2011-03-22 |
| 1811207384 | Josephine Bufalino | Emergency Medicine | 293 S Grand Ave, Pasadena, CA 91105-1623 | 2010-10-18 |
| 1235364167 | Allison Daum | Emergency Medicine | 5161 E Sam Houston Pkwy S, Pasadena, TX 77505-3915 | 2009-05-21 |
| 1972629707 | Lawrence Jeffrey Rudd | Emergency Medicine | 1414 Ridge Way, Pasadena, CA 91106-4516 | 2007-03-22 |
| 1902902257 | Stanton C. Packard | Emergency Medicine | 4002 Burke Rd, Pasadena, TX 77504-3451 | 2006-09-15 |
| 1386758746 | James Daniel Luna | Emergency Medicine | 100 California Blvd, Pasadena, CA 91105-1510 | 2006-08-19 |
| 1699792127 | Robert Alan Yoho | Emergency Medicine | 797 S Arroyo Pkwy, Pasadena, CA 91105-3234 | 2006-07-17 |
| 1689618464 | Dirk De Brito | Emergency Medicine | 751 N Fair Oaks Ave, Suite 300, Pasadena, CA 91103-3069 | 2006-06-15 |
| Find all providers in PASADENA | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.