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General NPI Number Information
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NPI Number | 1790052819
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Entity Type | Individual
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Provider Name | EMIL FLORENDO VASQUEZ P.A.C.
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Gender | Male
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Dates
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Enumeration Date | 11/17/2011
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Last Update Date | 08/13/2019
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Provider Practice Location Address
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Address Line | 9119 HASKELL AVE
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City | NORTH HILLS
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State | CA
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Zip | 91343
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Country | US
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Telephone | 818-763-8836
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Fax | 818-221-4747
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Provider Business Mailing Address
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Address Line | 9119 HASKELL AVE
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City | NORTH HILLS
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State | CA
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Zip | 91343-3121
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Country | US
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Telephone | 818-763-8836
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Fax | 818-221-4747
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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 | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | 21993
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License Number State | CA
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