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General NPI Number Information
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NPI Number | 1699729335
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Entity Type | Individual
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Provider Name | DOLORES A VILLACARLOS MD
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Gender | Female
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Dates
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Enumeration Date | 05/19/2006
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Last Update Date | 05/29/2025
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Provider Practice Location Address
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Address Line | 2040 PACIFIC COAST HWY STE S
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City | LOMITA
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State | CA
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Zip | 90717-2660
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Country | US
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Telephone | 424-347-8008
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Fax | 844-481-9664
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Provider Business Mailing Address
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Address Line | 2040 PACIFIC COAST HWY STE S
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City | LOMITA
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State | CA
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Zip | 90717-2660
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Country | US
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Telephone | 424-347-8008
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Fax | 844-481-9664
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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 | 207RG0300X
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Taxonomy Name | Geriatric Medicine (Internal Medicine) Physician
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License Number | A35717
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | A35717
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License Number State | CA
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