Healthcare Provider Details

I. General information

NPI: 1376473017
Provider Name (Legal Business Name): MS. SANDRA VARGAS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/22/2026
Last Update Date: 05/22/2026
Certification Date: 05/22/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

856 HEALTH SCIENCES RD
IRVINE CA
92617-3058
US

IV. Provider business mailing address

2208 CENTRAL AVE
FULLERTON CA
92831-3506
US

V. Phone/Fax

Practice location:
  • Phone: 949-824-1991
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number54381
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: