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1265969323
IVAN VILLANEDA
SAN FRANCISCO, CA
NPI
1265969323
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
2255A2300X Specialist/Technologist, Athletic Trainer
Enumeration Date
2017-05-18
Last Update Date
2017-05-18
Business Address
IVAN VILLANEDA ATC
79 NEW MONTGOMERY ST
SAN FRANCISCO, CA 94105-3410
Phone number: 909-295-1320
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Mailing Address
IVAN VILLANEDA ATC
16135 HARVEST MOON ST
LA PUENTE, CA 91744-1337
Phone number: 909-295-1320
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