Organization Active NPI

Maria Theresa O Villa, PC

  • Family Medicine Physician
  • San Diego, CA
National Provider Identifier
1992513113
Registry record updated Dec 19, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
MARIA THERESA O VILLA, PC
Practice address
655 Saturn Blvd Ste J
San Diego, CA 92154-4734
Phone
(619) 646-7975
NPI assigned
Dec 19, 2024
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 19, 2024

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

Authorized official

Name
George Ponce, MD
Title
Ceo
Phone
(951) 347-4823

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207Q00000X Primary

Addresses

Primary practice location

655 Saturn Blvd Ste J
San Diego, CA 92154-4734

Mailing address

655 Saturn Blvd Ste J
San Diego, CA 92154-4734
Phone (619) 646-7975

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
05D0970628Maria Theresa O Villa, MD655 Saturn Blvd Ste J, San Diego, CA 92154Certificate of waiverMar 23, 2028

National Provider Directory

National Provider Directory

Locations

655 Saturn Blvd
Ste J
San Diego, CA 92154
Phone (619) 575-4442

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1734566400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1734566400000",
    "number": "1992513113",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "655 SATURN BLVD STE J",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921544734",
            "telephone_number": "619-646-7975"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "655 SATURN BLVD STE J",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921544734",
            "telephone_number": "619-646-7975"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MARIA THERESA O VILLA, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-12-19",
        "last_updated": "2024-12-19",
        "certification_date": "2024-12-19",
        "status": "A",
        "authorized_official_last_name": "PONCE",
        "authorized_official_first_name": "GEORGE",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "951-347-4823",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Diego, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 19, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.