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General NPI Number Information
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NPI Number | 1487617361
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Entity Type | Organization
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Legal Business Name | ANTHONY L. VILLANUEVA,M.D., INC.
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Dates
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Enumeration Date | 04/10/2006
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Last Update Date | 07/25/2007
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Provider Practice Location Address
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Address Line | 901 CAMPUS DR SUITE 203
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City | DALY CITY
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State | CA
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Zip | 94015-4900
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Country | US
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Telephone | 650-992-2010
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Fax | 650-994-1421
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Provider Business Mailing Address
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Address Line | 901 CAMPUS DR SUITE 203
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City | DALY CITY
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State | CA
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Zip | 94015-4930
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Country | US
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Telephone | 650-992-2010
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Fax | 650-994-1421
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. ANTHONY LOUIS VILLANUEVA
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Credential | M.D.
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Telephone | 650-992-2010
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207W00000X
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Taxonomy Name | Ophthalmology Physician
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License Number | A39828
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License Number State | CA
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