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NPI Code Detail

MEDICARE: STEPHEN VILLA JR.

MEDICARE:   STEPHEN  VILLA JR.
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
1207P00000XEmergency Medicine PhysicianA145811CA

General Provider Information

NPI Number : 1538553755
Entity Type Code : Individual
Provider Name (Legal Business Name) : STEPHEN VILLA JR.
Provider Business Mailing Address
First Line : 5767 W CENTURY BLVD STE 400
Second Line :
City : LOS ANGELES
State : CA
Zip : 90045-5631
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 757 WESTWOOD PLZ STE 1517
Second Line :
City : LOS ANGELES
State : CA
Zip : 90095-2204
Country : US
Telephone Number : 310-267-3710
Fax Number : 310-794-0599
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/25/2015
Last Update Date : 11/05/2019

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Directions to “ STEPHEN VILLA JR. ” Practice Location

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