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NPI Code Detail

MEDICARE: ALBERT VASQUEZ P.A.-C

MEDICARE: ALBERT VASQUEZ P.A.-C
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
1363A00000XPhysician AssistantCA

General Provider Information

NPI Number : 1336521681
Entity Type Code : Individual
Provider Name (Legal Business Name) : ALBERT VASQUEZ P.A.-C
Provider Business Mailing Address
First Line : 1180 TRAILSIDE CIR
Second Line :
City : CONCORD
State : CA
Zip : 94518-2185
Country : US
Telephone Number : 209-499-9037
Fax Number :
Provider Business Practice Location Address
First Line : 1180 TRAILSIDE CIR
Second Line :
City : CONCORD
State : CA
Zip : 94518-2185
Country : US
Telephone Number : 209-499-9037
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/23/2015
Last Update Date : 06/23/2015

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