Healthcare Provider Details

I. General information

NPI: 1326689670
Provider Name (Legal Business Name): MARGARITA ELSA VILLARINO MD MPH
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: MARGARITA VILLARINO MD MPH

II. Dates (important events)

Enumeration Date: 10/07/2019
Last Update Date: 10/07/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

976 LENZEN AVE STE 1700
SAN JOSE CA
95126-2737
US

IV. Provider business mailing address

31817 VIA DEL PASO
WINCHESTER CA
92596-8603
US

V. Phone/Fax

Practice location:
  • Phone: 669-287-8095
  • Fax:
Mailing address:
  • Phone: 678-595-6271
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2083P0901X
TaxonomyPublic Health & General Preventive Medicine Physician
License Number165914
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: