Individual
DWIGHT MARSHALL TAN VILLANUEVA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
RRT
Contact information
Practice address
3440 E LA PALMA AVE, ANAHEIM, CA 92806-2020
(714) 644-2000
Mailing address
18518 BETTY WAY, CERRITOS, CA 90703-6320
(714) 684-4257
Taxonomy
Speciality
Code
Description
License number
State
227900000X
Registered Respiratory Therapist
Primary
25583
CA
Other
Enumeration date
08/17/2018
Last updated
12/01/2021
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