Most Relevant Information
Provider Data
| NPI Number: | 1003599242 |
| Provider Name: | ALEXIS VILLANUEVA BUENAVENTURA |
| Entity Type: | Individual |
| Taxonomy Code: | 2255A2300X |
| Specialty: | Specialist/Technologist |
| License Number: | Y7143218 |
Most Important Dates
| Enumeration Date: | 08/14/2023 |
| Last Updated: | 08/14/2023 |
Provider Practice Location
290 S PROSPECT AVE STE A
TUSTIN
CA
927801523
Practice Location Phone/Fax
| Phone: | 4156466223 |
| Fax: |
Provider Mailing Location
2700 PETERSON PL APT 48C
COSTA MESA
CA
926265370
Provider Mailing Phone/Fax
| Phone: | 2134003002 |
| Fax: |