Provider Demographics
NPI:1033318613
Name:VILA, LAURA M (NP)
Entity Type:Individual
Prefix:MRS
First Name:LAURA
Middle Name:M
Last Name:VILA
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:10901 CRENSHAW BLVD STE D
Mailing Address - Street 2:
Mailing Address - City:INGLEWOOD
Mailing Address - State:CA
Mailing Address - Zip Code:90303-5479
Mailing Address - Country:US
Mailing Address - Phone:310-677-5113
Mailing Address - Fax:310-677-5106
Practice Address - Street 1:10901 CRENSHAW BLVD STE D
Practice Address - Street 2:
Practice Address - City:INGLEWOOD
Practice Address - State:CA
Practice Address - Zip Code:90303-5479
Practice Address - Country:US
Practice Address - Phone:310-677-5113
Practice Address - Fax:310-677-5106
Is Sole Proprietor?:Yes
Enumeration Date:2007-07-13
Last Update Date:2007-07-13
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CA13255364SW0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes364SW0102XPhysician Assistants & Advanced Practice Nursing ProvidersClinical Nurse SpecialistWomen's Health