Juventino Villanueva

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

A46207 Issued in CA

Practice address

6601 Rugby Ave
300
Huntington Park, CA 90255-4040

Phone

(323) 582-1177

Fax

(323) 589-2635

NPI assigned

Aug 30, 2006

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in CA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Interoperability endpoints

• Direct secure messaging: jvillanueva41246@altamed.direct-ci.com

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Alpha Care Medical Group, Inc

  • Health Maintenance Organization
  • Pasadena, CA
  • NPI 1770655847
  NPD (past)
• Crown City Medical Group

  • Pediatrics Physician
  • San Bernardino, CA
  • NPI 1649602384
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1156896000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1327622400000",
    "number": "1164532446",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2589 E WASHINGTON BLVD",
            "city": "PASADENA",
            "state": "CA",
            "postal_code": "911071446",
            "telephone_number": "626-798-8792",
            "fax_number": "626-798-9607"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6601 RUGBY AVE",
            "address_2": "300",
            "city": "HUNTINGTON PARK",
            "state": "CA",
            "postal_code": "902554040",
            "telephone_number": "323-582-1177",
            "fax_number": "323-589-2635"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VILLANUEVA",
        "first_name": "JUVENTINO",
        "name_prefix": "Dr.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-30",
        "last_updated": "2012-01-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "CA",
            "license": "A46207",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDI-CAL",
            "identifier": "00A462070",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Oscar Victoria
• Adriana Villafana
• Carl William P Villafuerte
• Nelson Manrique Villalta, OPTICIAN
• Emily Villanueva
• Gabriela Villegas
• Jacqueline Villegas, LCSW
• Pamela Vines
• Claudia Alida Viscencio
• Vision Plus Optometry Inc

• Pediatrics Physician in Huntington Park, CA
• Providers in Huntington Park, CA by specialty
• Pediatrics Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 27, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.