Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 111NI0013X | Independent Medical Examiner | 19640 | CA |
NPI | 1609074079 |
---|---|
Provider Name | Robert J Villapania |
First Address | Rancho Cucamonga, CA 91730-2419 |
Second Address | Long Beach, CA 90805-4631 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 06/07/2007 |
Last Update Date | 31/10/2008 |