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General NPI Number Information
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NPI Number | 1861144842
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Entity Type | Organization
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Legal Business Name | VYNCA MEDICAL ASSOCIATES PA
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Dates
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Enumeration Date | 01/21/2022
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Last Update Date | 10/11/2024
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Provider Practice Location Address
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Address Line | 2355 STATE ST STE 101
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City | SALEM
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State | OR
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Zip | 97301-4541
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Country | US
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Telephone | 707-442-5683
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Fax | 707-440-8100
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Provider Business Mailing Address
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Address Line | 1875 S GRANT ST STE 760
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City | SAN MATEO
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State | CA
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Zip | 94402-2670
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Country | US
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Telephone | 707-442-5683
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Fax |
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Authorized Official
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Title or Position | PRINCIPAL OWNER
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Name | DR. JOSEPH JASSER
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Credential | MD
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Telephone | 707-442-5683
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207QH0002X
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Taxonomy Name | Hospice and Palliative Medicine (Family Medicine) Physician
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License Number |
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License Number State |
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