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NPI Code Detail

MEDICARE: JULIA BERYL WILLNER MD

MEDICARE: JULIA BERYL WILLNER MD
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207V00000XObstetrics & Gynecology PhysicianA96859CA

General Provider Information

NPI Number : 1891974655
Entity Type Code : Individual
Provider Name (Legal Business Name) : JULIA BERYL WILLNER MD
Provider Business Mailing Address
First Line : 200 S MANCHESTER AVE STE 130
Second Line :
City : ORANGE
State : CA
Zip : 92868-3216
Country : US
Telephone Number : 714-456-6707
Fax Number :
Provider Business Practice Location Address
First Line : 101 THE CITY DR S
Second Line :
City : ORANGE
State : CA
Zip : 92868-3201
Country : US
Telephone Number : 714-456-6707
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/29/2007
Last Update Date : 10/29/2007

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