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General NPI Number Information
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NPI Number | 1124951082
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Entity Type | Organization
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Legal Business Name | WILLETT MEDICAL GROUP, P.C.
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Dates
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Enumeration Date | 06/08/2026
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Last Update Date | 06/08/2026
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Provider Practice Location Address
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Address Line | 477 N EL CAMINO REAL STE C312
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City | ENCINITAS
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State | CA
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Zip | 92024-1328
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Country | US
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Telephone | 760-846-4424
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Fax | 760-589-1029
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Provider Business Mailing Address
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Address Line | 6812 CAMINITO SUENO
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City | CARLSBAD
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State | CA
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Zip | 92009-6001
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Country | US
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Telephone | 760-846-4424
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Fax | 760-589-1029
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Authorized Official
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Title or Position | MEDICAL DIRECTOR
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Name | DR. MATTHEW WILLETT
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Credential | MD
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Telephone | 760-846-4424
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207N00000X
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Taxonomy Name | Dermatology Physician
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License Number |
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License Number State |
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