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General NPI Number Information
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NPI Number | 1154381622
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Entity Type | Individual
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Provider Name | ANGELA VARGAS MD
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Gender | Female
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Dates
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Enumeration Date | 03/27/2006
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Last Update Date | 03/02/2012
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Provider Practice Location Address
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Address Line | 153 CESAR CHAVEZ ST
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City | W. ST PAUL
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State | MN
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Zip | 55107-2226
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Country | US
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Telephone | 651-222-1816
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Fax | 651-222-1305
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Provider Business Mailing Address
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Address Line | 153 CESAR CHAVEZ ST
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City | W. ST PAUL
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State | MN
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Zip | 55107-2226
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Country | US
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Telephone | 651-222-1816
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Fax | 651-222-1305
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 30841
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License Number State | MN
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