Provider Demographics
NPI:1528433687
Name:PAUL E VILLARUBIA DDS INC
Entity type:Organization
Organization Name:PAUL E VILLARUBIA DDS INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:PAUL
Authorized Official - Middle Name:ENTIENZA
Authorized Official - Last Name:VILLARUBIA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:714-635-2388
Mailing Address - Street 1:2270 W LINCOLN AVE
Mailing Address - Street 2:SUITE B
Mailing Address - City:ANAHEIM
Mailing Address - State:CA
Mailing Address - Zip Code:92801-6544
Mailing Address - Country:US
Mailing Address - Phone:714-635-2388
Mailing Address - Fax:
Practice Address - Street 1:2270 W LINCOLN AVE
Practice Address - Street 2:SUITE B
Practice Address - City:ANAHEIM
Practice Address - State:CA
Practice Address - Zip Code:92801-6544
Practice Address - Country:US
Practice Address - Phone:714-635-2388
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:PAUL E VILLARUBIA DDS INC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2015-12-01
Last Update Date:2015-12-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA55505302F00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes302F00000XManaged Care OrganizationsExclusive Provider Organization