Individual
RANDAL E VILLALOVAS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1000 RUSH DR, SALIDA, CO 81201-9627
(719) 530-2048
(719) 530-2055
Mailing address
550 W HWY 50, SALIDA, CO 81201-2238
(719) 530-2048
(719) 530-2055
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
52599
CO
207R00000X
Internal Medicine Physician
A60546
CA
207R00000X
Internal Medicine Physician
N4182
TX
208M00000X
Hospitalist Physician
A60546
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00A605460
—
CA
05
—
2156879-01
—
TX
05
—
215687902
—
TX
05
—
215687903
—
TX
Enumeration date
06/14/2006
Last updated
07/08/2015
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