Provider Demographics
NPI:1801023072
Name:VILLARREAL, HUMBERTO GUADALUPE (MD)
Entity Type:Individual
Prefix:DR
First Name:HUMBERTO
Middle Name:GUADALUPE
Last Name:VILLARREAL
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:PO BOX 512185
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90051-0185
Mailing Address - Country:US
Mailing Address - Phone:626-914-3921
Mailing Address - Fax:626-914-9611
Practice Address - Street 1:412 W CARROLL AVE STE 200
Practice Address - Street 2:
Practice Address - City:GLENDORA
Practice Address - State:CA
Practice Address - Zip Code:91741-4709
Practice Address - Country:US
Practice Address - Phone:626-914-3921
Practice Address - Fax:626-914-9611
Is Sole Proprietor?:No
Enumeration Date:2009-06-16
Last Update Date:2022-03-14
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
NE26150208800000X
IAMD-42204208800000X
CODR.0060186208800000X
CAC161226208800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208800000XAllopathic & Osteopathic PhysiciansUrology