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General NPI Number Information
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NPI Number | 1265486559
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Entity Type | Individual
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Provider Name | MARGARET GRACE DE VILLIERS M.D.
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Gender | Female
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Dates
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Enumeration Date | 05/20/2006
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Last Update Date | 03/07/2023
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Provider Practice Location Address
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Address Line | 812 POLLARD RD SUITE 1
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City | LOS GATOS
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State | CA
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Zip | 95032-1420
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Country | US
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Telephone | 408-374-1212
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Fax | 408-374-4160
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Provider Business Mailing Address
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Address Line | 812 POLLARD RD SUITE 1
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City | LOS GATOS
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State | CA
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Zip | 95032-1420
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Country | US
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Telephone | 408-374-1212
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Fax | 408-374-4160
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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 | 208000000X
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Taxonomy Name | Pediatrics Physician
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License Number | A42750
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License Number State | CA
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