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General NPI Number Information
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NPI Number | 1487914123
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Entity Type | Organization
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Legal Business Name | DR DORYS P VARGAS OPTOMETRIST INC
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Dates
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Enumeration Date | 05/28/2012
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Last Update Date | 06/15/2018
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Provider Practice Location Address
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Address Line | 1800 N PERRIS BLVD
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City | PERRIS
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State | CA
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Zip | 92571
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Country | US
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Telephone | 951-940-0463
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Fax | 951-443-1263
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Provider Business Mailing Address
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Address Line | 13389 BASHKIR ST
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City | EASTVALE
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State | CA
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Zip | 92880-3945
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Country | US
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Telephone | 562-481-2555
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Fax | 951-443-1263
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Authorized Official
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Title or Position | OWNER/ OPTOMETRIST
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Name | DR. DORYS P VARGAS
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Credential | O.D.
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Telephone | 562-481-2555
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 152W00000X
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Taxonomy Name | Optometrist
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License Number | 13515T
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License Number State | CA
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