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General NPI Number Information
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NPI Number | 1962026690
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Entity Type | Individual
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Provider Name | VERONICA VAZQUEZ DPT
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Gender | Female
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Dates
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Enumeration Date | 05/28/2020
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Last Update Date | 05/28/2020
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Provider Practice Location Address
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Address Line | 1450 N LAKE AVE
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City | PASADENA
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State | CA
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Zip | 91104-2387
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Country | US
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Telephone | 626-798-7805
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Fax |
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Provider Business Mailing Address
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Address Line | 762 E 45TH ST
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City | LOS ANGELES
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State | CA
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Zip | 90011-3604
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Country | US
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Telephone | 323-360-5455
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Fax |
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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 | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | PT298370
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License Number State | CA
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