# JOHN A GOROSTIZA VILLANUEVA MD, INC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** John A Gorostiza Villanueva MD, Inc Pain & Spine
- **Organization subpart:** No

## Provider details

- **NPI number:** 1528543394
- **Authorized official:** DR. JOHN A GOROSTIZA VILLANUEVA MD (DOCTOR AND OWNER)
- **Authorized official phone:** (626) 437-3661

## Contact information

- **Practice address:** 2121 W MAGNOLIA BLVD STE B, BURBANK, CA 91506
- **Practice address phone:** (818) 939-9398
- **Practice address fax:** (818) 626-3058
- **Mailing address:** 2121 W MAGNOLIA BLVD STE B, BURBANK, CA 91506-1706
- **Mailing address phone:** (626) 437-3661
- **Mailing address fax:** (818) 626-3058

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 208100000X | Physical Medicine & Rehabilitation Physician | — | NULL | Yes |
| 208100000X | Physical Medicine & Rehabilitation Physician | — | — | Yes |

## Other

- **Enumeration date:** 09/27/2018
- **Last updated:** 03/12/2019