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General NPI Number Information
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NPI Number | 1275000341
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Entity Type | Individual
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Provider Name | JOSE LUS VAZQUEZ RRT
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Gender | Male
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Dates
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Enumeration Date | 10/26/2018
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Last Update Date | 10/26/2018
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Provider Practice Location Address
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Address Line | 1515 N VERMONT AVE
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City | LOS ANGELES
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State | CA
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Zip | 90027-5329
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Country | US
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Telephone | 909-282-6800
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Fax |
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Provider Business Mailing Address
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Address Line | 562 LEWIS ST
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City | POMONA
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State | CA
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Zip | 91768-3447
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Country | US
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Telephone | 909-282-6800
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Fax |
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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 | 227900000X
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Taxonomy Name | Registered Respiratory Therapist
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License Number | 31411
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License Number State | CA
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