Provider Demographics
NPI:1972129658
Name:VILLAFLOR, CLIFFORD R SR
Entity Type:Individual
Prefix:MR
First Name:CLIFFORD
Middle Name:R
Last Name:VILLAFLOR
Suffix:SR
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:18800 AMAR RD STE B16
Mailing Address - Street 2:
Mailing Address - City:WALNUT
Mailing Address - State:CA
Mailing Address - Zip Code:91789-7101
Mailing Address - Country:US
Mailing Address - Phone:626-272-2754
Mailing Address - Fax:626-236-4146
Practice Address - Street 1:18800 AMAR RD STE B16
Practice Address - Street 2:
Practice Address - City:WALNUT
Practice Address - State:CA
Practice Address - Zip Code:91789-7101
Practice Address - Country:US
Practice Address - Phone:626-272-2754
Practice Address - Fax:626-236-4146
Is Sole Proprietor?:Yes
Enumeration Date:2020-06-18
Last Update Date:2020-06-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171WV0202XOther Service ProvidersContractorVehicle Modifications