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NPI Code Detail

MEDICARE: MR. THOMAS R VENDEGNA M.D

MEDICARE: MR. THOMAS R VENDEGNA 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
1207RP1001XPulmonary Disease PhysicianG83698CA
2207RC0200XCritical Care Medicine (Internal Medicine) PhysicianG83698CA

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1760468599
Entity Type Code : Individual
Provider Name (Legal Business Name) : MR. THOMAS R VENDEGNA M.D
Provider Business Mailing Address
First Line : 1304 ELLA ST STE A
Second Line :
City : SAN LUIS OBISPO
State : CA
Zip : 93401-4165
Country : US
Telephone Number : 805-549-9555
Fax Number : 805-549-0444
Provider Business Practice Location Address
First Line : 1304 ELLA ST STE A
Second Line :
City : SAN LUIS OBISPO
State : CA
Zip : 93401-4165
Country : US
Telephone Number : 805-549-9555
Fax Number : 805-549-0444
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/22/2005
Last Update Date : 11/08/2023

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