Individual
PETER P VILLASISTA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
631 N CORONADO ST APT 1, LOS ANGELES, CA 90026-3966
(323) 529-7545
Mailing address
631 N CORONADO ST APT 1, LOS ANGELES, CA 90026-3966
(323) 529-7545
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
AT10613
CA
Other
Enumeration date
01/08/2015
Last updated
01/08/2015
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