Individual
DINA L VILLAPUDUA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
9502 MONTERRA WAY, BUENA PARK, CA 90620-4260
(714) 469-8868
Mailing address
9502 MONTERRA WAY, BUENA PARK, CA 90620-4260
(714) 469-8868
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
PA 18416
CA
363A00000X
Physician Assistant
Primary
18416
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
GR0097000
PROVIDER NUMBER
CA
01
—
GR0097001
PROVIDER NUMBER
CA
Enumeration date
11/28/2006
Last updated
08/19/2015
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