MEDICARE: MARIE ALPUERTO-VILLAREAL

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	183500000X	Pharmacist	64795	CA
2	1835P0018X	Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist	APH10661	CA

General Provider Information

NPI Number	:	1396167011
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MARIE ALPUERTO-VILLAREAL

Provider Business Mailing Address
First Line	:	11908 ELLIOTT AVE
Second Line	:
City	:	EL MONTE
State	:	CA
Zip	:	91732-3741
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	4211 AVALON BLVD
Second Line	:
City	:	LOS ANGELES
State	:	CA
Zip	:	90011-5699
Country	:	US
Telephone Number	:	323-233-0425
Fax Number	:

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

Provider Enumeration Date	:	01/15/2014
Last Update Date	:	06/10/2026

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