Individual provider Active NPI

Paulo Villanueva, DC

  • Chiropractor
  • Lawndale, CA
National Provider Identifier
1710113113
Registry record updated Feb 13, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
DC 30720 Issued in CA
Practice address
15901 Hawthorne Blvd
Ste 420
Lawndale, CA 90260-5808
Phone
(626) 575-1211
Fax
(626) 575-1511
NPI assigned
May 31, 2009
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 13, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X DC 30720 CA Primary

Addresses

Primary practice location

15901 Hawthorne Blvd
Ste 420
Lawndale, CA 90260-5808

Mailing address

4940 W 99TH St
Inglewood, CA 90301-3612
Phone (310) 259-7748

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20110307000967 CA Practitioner - Chiropractic 6204018658

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
HHS exclusion list flag
Flagged The directory lists this NPI on an HHS exclusion list. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.

State licenses

LicenseStateTypeSpecialty
DC 30720CAMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Jameson Wong Chiropractic, PC Chiropractor Past Accepting new patients
Diep Neuro Spine Chiropractic Institute, a Professional Corporation Chiropractor PastSince Aug 28, 2022 Accepting new patients
Diep Chiropractic Wellness, Inc. Chiropractor PastSince Jan 18, 2011 Accepting new patients

Organizations & group practices 3

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": "1243728000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1581552000000",
    "number": "1710113113",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4940 W 99TH ST",
            "city": "INGLEWOOD",
            "state": "CA",
            "postal_code": "903013612",
            "telephone_number": "310-259-7748",
            "fax_number": "626-575-1511"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15901 HAWTHORNE BLVD",
            "address_2": "STE 420",
            "city": "LAWNDALE",
            "state": "CA",
            "postal_code": "902605808",
            "telephone_number": "626-575-1211",
            "fax_number": "626-575-1511"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VILLANUEVA",
        "first_name": "PAULO",
        "name_prefix": "Dr.",
        "credential": "DC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2009-05-31",
        "last_updated": "2020-02-13",
        "certification_date": "2020-02-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "CA",
            "license": "DC 30720",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lawndale, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 13, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.