Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Edie Willis, PA-C

Individual provider Medical Physician Assistant · NPI 1356877328

Edie Willis, PA-C is a Physician Assistant in Los Angeles, California. Qualified in 2017, 9 years ago. Practices with Nephrology and Hypertension Medical Associates PC, a 19-clinician group and accepts Medicare assignment. Licensed in California and Georgia.

Years since qualifying
9
Licensed in
CA, GA
In the registry since
2017
Specialties on file
2
What do these letters mean?
PA-C — Physician Assistant, Certified
A physician assistant who holds current national certification.

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Practice location Address checks out

1520 San Pablo St Ste 1000
Los Angeles, CA 90033-5312
Phone: (323) 442-5100
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Medical Physician Assistant (primary) Taxonomy 363AM0700X · Licence PA62067 (CA)
Medical Physician Assistant Taxonomy 363AM0700X · Licence 008351 (GA)

Record details

NPI number1356877328
Entity typeIndividual (Type 1)
GenderFemale
Credentials PA-C
Sole proprietorNo
NPI enumeratedMay 11, 2017
Last updated in NPPESMarch 14, 2023
Certification dateMarch 14, 2023

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolOTHER
Graduated 2017 (9 years in practice)
Group practice Nephrology And Hypertension Medical Associates Pc — 19 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations2 on file with Medicare

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