Individual provider Active NPI

Dolores A Villacarlos, MD

  • Family Medicine Physician
  • Lomita, CA
National Provider Identifier
1699729335
Registry record updated May 29, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
A35717 Issued in CA
Practice address
2040 Pacific Coast Hwy Ste S
Lomita, CA 90717-2660
Phone
(424) 347-8008
Fax
(844) 481-9664
NPI assigned
May 19, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 29, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Geriatric Medicine (Internal Medicine) Physician 207RG0300X A35717 CA
Family Medicine Physician 207Q00000X A35717 CA Primary

Addresses

Primary practice location

2040 Pacific Coast Hwy Ste S
Lomita, CA 90717-2660

Mailing address

2040 Pacific Coast Hwy Ste S
Lomita, CA 90717-2660
Phone (424) 347-8008

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
A35717CAMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Can Emergency Physicians Medical Group, Inc. Current Accepting new patients
Alta Newport Hospital, LLC Past Accepting new patients
Unified Care Medical Group, Inc. Past Accepting new patients
Brotman Medical Center, Inc. Past Accepting new patients
Alta Los Angeles Hospital, Inc Past Accepting new patients
Southern California Healthcare System, Inc Past Accepting new patients
Deanco Healthcare LLC. Past Accepting new patients
Cha Hollywood Medical Center, LP Past Accepting new patients

Locations

1225 Wilshire Blvd
Los Angeles, CA 90017
Phone (213) 482-2741

6245 De Longpre Ave
Los Angeles, CA 90028
Phone (310) 306-5502

13222 Bloomfield Ave
Norwalk, CA 90650
Phone (562) 207-9729

14662 Newport Ave
Tustin, CA 92780
Phone (714) 619-7700

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

Organizations & group practices 8

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.

NPI Registry JSON

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

{
    "created_epoch": "1147996800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1748476800000",
    "number": "1699729335",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2040 PACIFIC COAST HWY STE S",
            "city": "LOMITA",
            "state": "CA",
            "postal_code": "907172660",
            "telephone_number": "424-347-8008",
            "fax_number": "844-481-9664"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2040 PACIFIC COAST HWY STE S",
            "city": "LOMITA",
            "state": "CA",
            "postal_code": "907172660",
            "telephone_number": "424-347-8008",
            "fax_number": "844-481-9664"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VILLACARLOS",
        "first_name": "DOLORES",
        "middle_name": "A",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-05-19",
        "last_updated": "2025-05-29",
        "certification_date": "2025-05-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RG0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Geriatric Medicine",
            "state": "CA",
            "license": "A35717",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "A35717",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lomita, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 29, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.