Individual
MR. CARLOS VILLARREAL III
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
232 E GISH RD, SAN JOSE, CA 95112-4706
(408) 876-4106
(408) 876-4250
Mailing address
232 E GISH RD, SAN JOSE, CA 95112-4706
(408) 876-4106
(408) 876-4250
Taxonomy
Speciality
Code
Description
License number
State
251B00000X
Case Management Agency
Primary
—
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
171M00000X
EMQ
CA
Enumeration date
05/17/2012
Last updated
05/17/2012
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