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General NPI Number Information
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NPI Number | 1578666129
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Entity Type | Individual
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Provider Name | DANIEL MARK VILLAROSA M.D
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Gender | Male
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Dates
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Enumeration Date | 09/07/2006
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Last Update Date | 12/06/2023
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Provider Practice Location Address
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Address Line | 18064 WIKA RD STE102
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City | APPLE VALLEY
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State | CA
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Zip | 92307-2125
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Country | US
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Telephone | 760-242-6652
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Fax | 760-242-6642
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Provider Business Mailing Address
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Address Line | 18064 WIKA RD STE102
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City | APPLE VALLEY
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State | CA
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Zip | 92307-2125
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Country | US
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Telephone | 760-242-6652
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Fax | 760-242-6642
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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 | 174400000X
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Taxonomy Name | Specialist
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License Number | C50281
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 207V00000X
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Taxonomy Name | Obstetrics & Gynecology Physician
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License Number | C50281
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License Number State | CA
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