Individual provider Active NPI

Carlos Isaac Villarreal, PA

  • Physician Assistant
  • Whittier, CA
National Provider Identifier
1629301601
Registry record updated Oct 24, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
20538 Issued in CA
Practice address
15733 Whittier Blvd
Whittier, CA 90603-2312
Phone
(562) 947-7754
Fax
(562) 902-9599
NPI assigned
Sep 9, 2009
Last updated
Oct 24, 2026By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 24, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 20538 CA Primary

Addresses

Primary practice location

15733 Whittier Blvd
Whittier, CA 90603-2312

Mailing address

PO Box 11294
Whittier, CA 90603-0294
Phone (626) 824-8461

Medicare participation

Medicare enrollment files
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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20101129000972 CA Practitioner - Physician Assistant 6901092204 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Southern California Permanente Medical Group CurrentSince Jan 17, 2015 Accepting new patients
Southern California Permanente Medical Group CurrentSince Jan 17, 2015 Accepting new patients
New Hope Podiatry Group Inc. PastSince Dec 29, 2024 Accepting new patients

Locations

5475 E La Palma Ave
Anaheim, CA 92807
Phone (714) 279-6088

1011 Baldwin Park Blvd
Baldwin Park, CA 91706
Phone (626) 851-1011

1255 W Arrow Hwy
San Dimas, CA 91773
Phone (909) 394-2526

888 S Hill Rd
Ventura, CA 93003
Phone (805) 477-6400

5601 De Soto Ave
Woodland Hls, CA 91367
Phone (818) 719-2930

Organizations & group practices 4

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

NPI Registry JSON

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

{
    "created_epoch": "1252454400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1792800000000",
    "number": "1629301601",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 11294",
            "city": "WHITTIER",
            "state": "CA",
            "postal_code": "906030294",
            "telephone_number": "626-824-8461",
            "fax_number": "562-262-2032"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15733 WHITTIER BLVD",
            "city": "WHITTIER",
            "state": "CA",
            "postal_code": "906032312",
            "telephone_number": "562-947-7754",
            "fax_number": "562-902-9599"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VILLARREAL",
        "first_name": "CARLOS",
        "middle_name": "ISAAC",
        "name_prefix": "Mr.",
        "credential": "PA",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2009-09-09",
        "last_updated": "2026-10-24",
        "certification_date": "2026-10-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CA",
            "license": "20538",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Whittier, CA

Sources for this page

Verify at the official NPI Registry.