Individual
DR. KENNETH J VILLA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
525 3RD AVE, CHULA VISTA, CA 91910-5616
(619) 585-4044
(619) 585-4015
Mailing address
525 3RD AVE, CHULA VISTA, CA 91910-5616
(619) 585-4044
(619) 585-4015
Taxonomy
Speciality
Code
Description
License number
State
2084N0400X
Neurology Physician
Primary
G71718
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00G717180
—
CA
Enumeration date
08/31/2006
Last updated
06/27/2013
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