MR. JOSE L VILLAGOMEZ (NPI# 1699717462) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1699717462 |
Entity Type | Individual |
Full Name | MR. JOSE L VILLAGOMEZ |
Credential | MD |
Practice Address |
12099 W Washington Blvd Ste 400 Los Angeles CA 90066-5882 |
Practice Telephone | 3103983803 |
Practice Fax Number | 3103985189 |
Mailing Telephone | 3103983803 |
Mailing Fax Number | 3103985189 |
Enumeration Date | 2006-06-13 |
Last Update Date | 2011-02-22 |
Gender Code | M |
Is Sole Proprietor | N |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
N | 207P00000X | Emergency Medicine | A61283 | CA | Allopathic & Osteopathic Physicians |
Y | 208D00000X | General Practice | A61283 | CA | Allopathic & Osteopathic Physicians |
State | Issuer | Identifier | Type Code |
---|---|---|---|
CAQH | 11613705 | 01 | |
CA | 00A612830 | 05 | |
CA | MEDICAL | 00A612830 | 01 |
Street Address |
12099 W WASHINGTON BLVD STE 400 |
City | LOS ANGELES |
State | CA |
Zip Code | 90066-5882 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1346854403 | Adrianna Franco | Student in an Organized Health Care Education/Training Program | 12099 W Washington Blvd, Los Angeles, CA 90066-5882 | 2020-09-04 |
1861036956 | Kenia P Martinez | Case Manager/Care Coordinator | 12099 W Washington Blvd, Los Angeles, CA 90066-5882 | 2019-10-31 |
1881243178 | Jenny Pinto | Student in an Organized Health Care Education/Training Program | 12099 W Washington Blvd, Los Angeles, CA 90066-5882 | 2019-09-09 |
1508411125 | Desiree Pacheco | Rehabilitation Practitioner | 12099 W Washington Blvd, Los Angeles, CA 90066-5882 | 2019-08-09 |
1720633183 | Bianca Jaelyn Collazo | Marriage & Family Therapist | 12099 W Washington Blvd, Los Angeles, CA 90066-5882 | 2019-08-02 |
1295296580 | Shugar Jones | Case Manager/Care Coordinator | 12099 W Washington Blvd, Los Angeles, CA 90066-5882 | 2019-03-28 |
1982188900 | Wendi Jessica Avila | Counselor | 12099 W Washington Blvd, Los Angeles, CA 90066-5882 | 2018-09-17 |
1609382308 | Karina Del Campo | Case Manager/Care Coordinator | 12099 W Washington Blvd, Los Angeles, CA 90066-5882 | 2017-12-18 |
1467982280 | Kevin Emilio Perez | Rehabilitation Practitioner | 12099 W Washington Blvd, Los Angeles, CA 90066-5882 | 2017-06-14 |
1225561822 | Deborah A Gill | Case Manager/Care Coordinator | 12099 W Washington Blvd, Suite 200, Los Angeles, CA 90066-5882 | 2017-04-10 |
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NPI | Name | Taxonomy | Address | Enumeration |
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1194330274 | Marilyn S Zweifach | Psychologist | 3606 Barry Avenue, Los Angeles, CA 90066 | 2020-09-15 |
1073167458 | Rosario Tabares | Marriage & Family Therapist | 4173 Inglewood Blvd., Los Angeles, CA 90066 | 2019-07-24 |
1396200739 | Ruzziel Pio | Licensed Vocational Nurse | 4344 Harding Avenue, Los Angeles, CA 90066 | 2019-02-08 |
1164992731 | Erfan Nazeri | Student in an Organized Health Care Education/Training Program | 3101 Sawtelle Blvd, Apt 128, Los Angeles, CA 90066 | 2018-11-27 |
1972096600 | Tricia Kim Ann Walters | Licensed Vocational Nurse | 1233 S. La Cienega Blvd, Los Angeles, CA 90066 | 2018-06-07 |
1174015622 | Nicole Hiorns | Occupational Therapist | 11605 Washington Place, Los Angeles, CA 90066 | 2018-05-31 |
1225549934 | Gary Sattler | Psychoanalyst | 3133 Federal Ave., Los Angeles, CA 90066 | 2017-10-20 |
1669991568 | Nexus Recovery Services, LLC | Clinic/Center | 11515 Washington Blvd, Culver City, CA 90066 | 2017-09-12 |
1336669381 | Andrea Michelle Bakke | Dentist | 3636 Rosewood Ave, Los Angeles, CA 90066 | 2017-06-21 |
1659820686 | Pegah Ghassemi Bakhtiari Dds Inc | Dentist | 12756 West Washington Blvd, Los Angeles, CA 90066 | 2016-10-03 |
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Taxonomy Code | 208D00000X |
Grouping | Allopathic & Osteopathic Physicians |
Classification | General Practice |
Definition to come... |
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Find all providers in LOS ANGELES |
City | LOS ANGELES |
Zip Code | 90066 |
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Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.