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General NPI Number Information
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NPI Number | 1831116540
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Entity Type | Organization
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Legal Business Name | EDWARD A. VANEK, D.O., INC.
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Dates
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Enumeration Date | 07/17/2006
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Last Update Date | 02/13/2019
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Provider Practice Location Address
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Address Line | 3140 APRON AVE
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City | ATWATER
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State | CA
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Zip | 95301-5103
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Country | US
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Telephone | 209-385-1244
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Fax | 209-385-1247
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Provider Business Mailing Address
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Address Line | 3140 APRON AVE
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City | ATWATER
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State | CA
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Zip | 95301-5103
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Country | US
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Telephone | 209-385-1244
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Fax | 209-385-1247
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Authorized Official
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Title or Position | DO
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Name | EDWARD ANTHONY VANEK
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Credential |
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Telephone | 209-385-1244
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207X00000X
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Taxonomy Name | Orthopaedic Surgery Physician
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License Number | 20A9591
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License Number State | CA
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