Provider Demographics
NPI:1831431246
Name:VILLAREAL, DAVID EDWARD (RPH)
Entity type:Individual
Prefix:MR
First Name:DAVID
Middle Name:EDWARD
Last Name:VILLAREAL
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:570 MUNRAS AVE
Mailing Address - Street 2:SUITE 10
Mailing Address - City:MONTEREY
Mailing Address - State:CA
Mailing Address - Zip Code:93940-3014
Mailing Address - Country:US
Mailing Address - Phone:831-333-0751
Mailing Address - Fax:831-333-0759
Practice Address - Street 1:570 MUNRAS AVE
Practice Address - Street 2:SUITE 10
Practice Address - City:MONTEREY
Practice Address - State:CA
Practice Address - Zip Code:93940-3014
Practice Address - Country:US
Practice Address - Phone:831-333-0751
Practice Address - Fax:831-333-0759
Is Sole Proprietor?:No
Enumeration Date:2013-03-24
Last Update Date:2013-03-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CARPH38336183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist