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General NPI Number Information
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NPI Number | 1154097293
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Entity Type | Individual
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Provider Name | CHRISTOPHER VILLANUEVA DALATEN PA-C
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Gender | Male
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Dates
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Enumeration Date | 08/18/2021
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Last Update Date | 06/03/2025
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Provider Practice Location Address
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Address Line | 1700 E CESAR E CHAVEZ AVE STE 2500
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City | LOS ANGELES
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State | CA
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Zip | 90033-2434
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Country | US
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Telephone | 323-268-6731
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Fax |
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Provider Business Mailing Address
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Address Line | 14650 AVIATION BLVD STE 200
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City | HAWTHORNE
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State | CA
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Zip | 90250-6670
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Country | US
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Telephone | 323-306-9632
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | PA60245
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License Number State | CA
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