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Contact Information

PURITA Z VILLANUEVA, MD
1208 FLOYD AVENUE
SUITE B-8
MODESTO, CA95350
 Phone: 209-521-3160
 Fax: 209-521-3150
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Procedural Dermatology

207NS0135X 07 Physician/Dermatology
Indicates primary specialty

NPI Profile & details for PURITA Z VILLANUEVA · (Female)

NPI Number 1164503496
Status Active
Credentials MD
Entity Individual
Enumeration date 10/17/2006
Last updated 10/01/2009 - About 17 years ago
Sole proprietor 1 Yes
Identifiers
  • CA License # A44551
  • CA Other ZZZ48224Z MEDICARE IDENTIFICATION #
  • CA Other CD278Z MEDICARE PTAN
  • CA Other P00392834 RAILROAD MEDICARE
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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