Individual
FELIPE VILLENA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
6501 COYLE AVE, CARMICHAEL, CA 95608-0306
(916) 537-5000
(916) 851-2884
Mailing address
PO BOX 7096, STOCKTON, CA 95267-0096
(209) 956-7725
(209) 956-7733
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
02002220A
IN
207L00000X
Anesthesiology Physician
Primary
20A10074
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0AX100740
—
CA
01
—
20A100740
BLUE SHIELD
CA
Enumeration date
02/15/2006
Last updated
12/17/2021
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