Healthcare Provider Details

I. General information

NPI: 1336412063
Provider Name (Legal Business Name): VINCENT-ARTHUR ARUIZA YORO-BACAY MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/10/2012
Last Update Date: 07/30/2021
Certification Date: 07/30/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

26600 CACTUS AVE STE 300
MORENO VALLEY CA
92555-3901
US

IV. Provider business mailing address

26600 CACTUS AVE STE 300
MORENO VALLEY CA
92555-3901
US

V. Phone/Fax

Practice location:
  • Phone: 951-988-9500
  • Fax:
Mailing address:
  • Phone: 951-988-9500
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberA167236
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: