MEDICARE: DR. RICARDO RAFAEL VEGA 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
1	207RP1001X	Pulmonary Disease Physician	A65736	CA
2	207RS0012X	Sleep Medicine (Internal Medicine) Physician	A65736	CA

Other Identifiers

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

General Provider Information

NPI Number	:	1982607750
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. RICARDO RAFAEL VEGA M.D.

Provider Business Mailing Address
First Line	:	27699 JEFFERSON AVE
Second Line	:	STE 204
City	:	TEMECULA
State	:	CA
Zip	:	92590-2696
Country	:	US
Telephone Number	:	951-225-1116
Fax Number	:	951-225-1103

Provider Business Practice Location Address
First Line	:	27699 JEFFERSON AVE STE 204
Second Line	:
City	:	TEMECULA
State	:	CA
Zip	:	92590
Country	:	US
Telephone Number	:	951-225-1116
Fax Number	:	951-225-1103

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/24/2005
Last Update Date	:	08/14/2018

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