Provider Demographics
NPI:1790743359
Name:VILLAGOMEZ, SILVIA M (MD)
Entity Type:Individual
Prefix:DR
First Name:SILVIA
Middle Name:M
Last Name:VILLAGOMEZ
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:300 FRANK H OGAWA PLZ STE 355
Mailing Address - Street 2:
Mailing Address - City:OAKLAND
Mailing Address - State:CA
Mailing Address - Zip Code:94612-2088
Mailing Address - Country:US
Mailing Address - Phone:510-444-3297
Mailing Address - Fax:510-444-6421
Practice Address - Street 1:300 FRANK H OGAWA PLZ STE 355
Practice Address - Street 2:
Practice Address - City:OAKLAND
Practice Address - State:CA
Practice Address - Zip Code:94612-2088
Practice Address - Country:US
Practice Address - Phone:510-444-3297
Practice Address - Fax:510-444-6421
Is Sole Proprietor?:No
Enumeration Date:2006-05-03
Last Update Date:2023-11-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG71593207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAZZZ23860ZMedicare ID - Type Unspecified
CA00G715932Medicare PIN
F49283Medicare UPIN