Individual
ERIC VILLANUEVA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
7090 MIRATECH DR, SAN DIEGO, CA 92121-3109
(858) 304-6440
Mailing address
22826 OAK KNOLL DR, CARSON, CA 90745-4750
(562) 412-7670
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
50927
CA
225200000X
Physical Therapy Assistant
—
—
Other
Enumeration date
11/06/2020
Last updated
10/06/2021
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