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General NPI Number Information
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NPI Number | 1730314006
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Entity Type | Organization
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Legal Business Name | JULIO C. VEGA, M.D. INC
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Dates
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Enumeration Date | 05/15/2009
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Last Update Date | 05/15/2009
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Provider Practice Location Address
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Address Line | 11100 WARNER AVE. #302
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City | FOUNTAIN VALLEY
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State | CA
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Zip | 92708
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Country | US
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Telephone | 714-850-1872
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Fax | 714-850-1874
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Provider Business Mailing Address
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Address Line | 11100 WARNER AVE. #302
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City | FOUNTAIN VALLEY
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State | CA
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Zip | 92708
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Country | US
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Telephone | 714-850-1872
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Fax | 714-850-1874
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Authorized Official
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Title or Position | PHYSICIAN - CORP. PRESIDENT
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Name | JULIO C. VEGA
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Credential | M.D.
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Telephone | 714-850-1872
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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 | A33429
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 208D00000X
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Taxonomy Name | General Practice Physician
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License Number | A33429
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License Number State | CA
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Taxonomy #3
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Taxonomy Code | 208600000X
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Taxonomy Name | Surgery Physician
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License Number | A33429
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License Number State | CA
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