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NPI Code Detail

MEDICARE: DR. VANCE LAIDLAW FLETCHER M.D.

MEDICARE: DR. VANCE LAIDLAW FLETCHER M.D.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207QA0505XAdult Medicine PhysicianC186960CA

General Provider Information

NPI Number : 1336210061
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. VANCE LAIDLAW FLETCHER M.D.
Provider Business Mailing Address
First Line : 91275 66TH AVE
Second Line :
City : MECCA
State : CA
Zip : 92254-1251
Country : US
Telephone Number : 760-396-1249
Fax Number : 760-396-1253
Provider Business Practice Location Address
First Line : 91275 66TH AVE
Second Line :
City : MECCA
State : CA
Zip : 92254-1251
Country : US
Telephone Number : 760-396-1249
Fax Number : 760-396-1253
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/13/2006
Last Update Date : 10/16/2024

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