MEDICARE: DR. ANTHONY LOUIS VILLANUEVA M.D.

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
1	207W00000X	Ophthalmology Physician	A39828	CA

General Provider Information

NPI Number	:	1750344636
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. ANTHONY LOUIS VILLANUEVA M.D.

Provider Business Mailing Address
First Line	:	901 CAMPUS DR
Second Line	:	SUITE 203
City	:	DALY CITY
State	:	CA
Zip	:	94015-4900
Country	:	US
Telephone Number	:	650-992-2010
Fax Number	:	650-994-1421

Provider Business Practice Location Address
First Line	:	901 CAMPUS DR
Second Line	:	SUITE 203
City	:	DALY CITY
State	:	CA
Zip	:	94015-4900
Country	:	US
Telephone Number	:	650-992-2010
Fax Number	:	650-994-1421

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/10/2006
Last Update Date	:	08/26/2010

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Directions to “ DR. ANTHONY LOUIS VILLANUEVA M.D.” Practice Location

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