Provider Demographics
NPI:1629689088
Name:DEL VILLAR, MIGUEL ANGEL (RN,CSN)
Entity type:Individual
Prefix:
First Name:MIGUEL
Middle Name:ANGEL
Last Name:DEL VILLAR
Suffix:
Gender:M
Credentials:RN,CSN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5755 OBERLIN DR STE 301
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92121-4717
Mailing Address - Country:US
Mailing Address - Phone:888-316-0439
Mailing Address - Fax:858-786-1260
Practice Address - Street 1:5755 OBERLIN DR STE 301
Practice Address - Street 2:
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92121-4717
Practice Address - Country:US
Practice Address - Phone:888-316-0439
Practice Address - Fax:858-786-1260
Is Sole Proprietor?:Yes
Enumeration Date:2020-08-11
Last Update Date:2024-12-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA95138125163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse