Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LA2100X | Nurse Practitioner - Acute Care | 20273 | CA |
NPI | 1033408844 |
---|---|
Provider Name | Maximiano Villalpando |
First Address | Los Angeles, CA 90063 |
Second Address | Los Angeles, CA 90033-1352 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 01/04/2011 |
Last Update Date | 04/04/2011 |