Gilmore A Villegas
Rehabilitation Practitioner in Los Angeles, CA. Individual provider (NPI-1).
NPI number1558092239
StatusActive
Last updated in NPPESApr 17, 2025
Details
- NPI
- 1558092239
- Entity type
- Individual (NPI-1)
- Name
- Gilmore A Villegas
- Sex
- Male
- Sole proprietor
- No
- Enumeration date
- Jun 22, 2022
- Certification date
- Apr 17, 2025
- Last updated
- Apr 17, 2025
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 225400000X | Rehabilitation Practitioner | – | – | Yes |
| 171M00000X | Case Manager/Care Coordinator | – | – |
Practice location
3580 Wilshire Blvd Ste 2000Los Angeles, CA 90010-2533
Phone 213-381-1250 · Fax 213-383-4803
Mailing address
3580 Wilshire Blvd Ste 2000Los Angeles, CA 90010-2533
Phone 213-381-1250 · Fax 213-383-4803
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