Individual
RYAN HENRY VILLAMATER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA
Contact information
Practice address
100 UCLA MEDICAL PLZ STE 630, LOS ANGELES, CA 90024-6997
(310) 825-9011
Mailing address
5767 W CENTURY BLVD, SUITE 400, LOS ANGELES, CA 90045-5631
(310) 825-9820
Taxonomy
Speciality
Code
Description
License number
State
363AS0400X
Surgical Physician Assistant
Primary
PA19639
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0PA196390
—
CA
Enumeration date
10/17/2006
Last updated
01/25/2024
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