Provider Demographics
NPI:1053516716
Name:TONG-VILLANUEVA, ANTHONY ERIC (RPH)
Entity type:Individual
Prefix:
First Name:ANTHONY
Middle Name:ERIC
Last Name:TONG-VILLANUEVA
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:ANTHONY
Other - Middle Name:E
Other - Last Name:VILLANUEVA
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:RPH
Mailing Address - Street 1:12254 BELLFLOWER BLVD
Mailing Address - Street 2:2ND FLOOR, PHARMACY INFORMATICS
Mailing Address - City:DOWNEY
Mailing Address - State:CA
Mailing Address - Zip Code:90242-2804
Mailing Address - Country:US
Mailing Address - Phone:562-658-3641
Mailing Address - Fax:562-658-3776
Practice Address - Street 1:12254 BELLFLOWER BLVD
Practice Address - Street 2:2ND FLOOR, PHARMACY INFORMATICS
Practice Address - City:DOWNEY
Practice Address - State:CA
Practice Address - Zip Code:90242-2804
Practice Address - Country:US
Practice Address - Phone:562-658-3641
Practice Address - Fax:562-658-3776
Is Sole Proprietor?:No
Enumeration Date:2007-06-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA42073183500000X
NMRP00004879183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist