Individual
JUAN PABLO VILLABLANCA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
757 WESTWOOD PLZ STE 1501, LOS ANGELES, CA 90095-3075
(310) 301-6800
(310) 794-9035
Mailing address
5767 W CENTURY BLVD STE 400, LOS ANGELES, CA 90045-5631
Taxonomy
Speciality
Code
Description
License number
State
2085N0700X
Neuroradiology Physician
G70784
CA
2085R0202X
Diagnostic Radiology Physician
G70784
CA
2085R0204X
Vascular & Interventional Radiology Physician
Primary
G70784
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00G707840
—
CA
Enumeration date
05/12/2006
Last updated
06/09/2022
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