Healthcare Provider Details

I. General information

NPI: 1235464967
Provider Name (Legal Business Name): JOSEPH VARDAYO M D INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/14/2009
Last Update Date: 10/31/2025
Certification Date: 10/31/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

701 E 28TH ST STE 400
LONG BEACH CA
90806-2778
US

IV. Provider business mailing address

701 E 28TH ST STE 400
LONG BEACH CA
90806-2778
US

V. Phone/Fax

Practice location:
  • Phone: 562-981-9308
  • Fax: 562-981-9318
Mailing address:
  • Phone: 562-981-9308
  • Fax: 562-981-9318

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QA1903X
TaxonomyAmbulatory Surgical Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: DR. JOSEPH FAMIL VARDAYO
Title or Position: DIRECTOR
Credential: M.D.
Phone: 562-981-9308