MEDICARE: DR. MARIA FE BELLEN VILLOSIS M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	208000000X	Pediatrics Physician	A89786	CA
2	2080N0001X	Neonatal-Perinatal Medicine Physician	A89786	CA

General Provider Information

NPI Number	:	1285672741
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. MARIA FE BELLEN VILLOSIS M.D.

Provider Business Mailing Address
First Line	:	1240 N MISSION RD
Second Line	:
City	:	LOS ANGELES
State	:	CA
Zip	:	90033-1019
Country	:	US
Telephone Number	:	323-226-3406
Fax Number	:	323-226-3440

Provider Business Practice Location Address
First Line	:	1240 N MISSION RD
Second Line	:
City	:	LOS ANGELES
State	:	CA
Zip	:	90033-1019
Country	:	US
Telephone Number	:	323-226-3406
Fax Number	:	323-226-3440

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/04/2006
Last Update Date	:	10/14/2021

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