Individual
ANTONIO VILLALVAZO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
6191 N FRESNO ST, SUITE 101, FRESNO, CA 93710-8612
(559) 227-1663
(559) 227-9083
Mailing address
6191 N FRESNO ST, SUITE 101, FRESNO, CA 93710-8612
(559) 227-1663
(559) 227-9083
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
C52080
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
5430437
—
CA
Enumeration date
09/20/2006
Last updated
08/17/2011
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