Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207KA0200X | Allergist | A19710 | CA |
NPI | 1255345807 |
---|---|
Provider Name | Mr. James W Villaveces |
First Address | Ventura, CA 93003-1811 |
Second Address | Ventura, CA 93003-1811 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 28/07/2006 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
A21846 | (02) | CA |