Healthcare Provider Details

I. General information

NPI: 1831056415
Provider Name (Legal Business Name): CARLOS SABAS VILLARREAL
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/06/2026
Last Update Date: 01/06/2026
Certification Date: 01/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5601 E SLAUSON AVE
COMMERCE CA
90040-2953
US

IV. Provider business mailing address

5601 E SLAUSON AVE
COMMERCE CA
90040-2953
US

V. Phone/Fax

Practice location:
  • Phone: 562-842-7330
  • Fax:
Mailing address:
  • Phone: 562-842-7330
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code373H00000X
TaxonomyDay Training/Habilitation Specialist
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: