Provider Demographics
NPI:1003932005
Name:FUERY, VICTOR LORIN III (LVN)
Entity Type:Individual
Prefix:MR
First Name:VICTOR
Middle Name:LORIN
Last Name:FUERY
Suffix:III
Gender:M
Credentials:LVN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:2807 SAINT JAMES PL
Mailing Address - Street 2:
Mailing Address - City:ALTADENA
Mailing Address - State:CA
Mailing Address - Zip Code:91001-1932
Mailing Address - Country:US
Mailing Address - Phone:323-443-3279
Mailing Address - Fax:323-443-3267
Practice Address - Street 1:2807 SAINT JAMES PL
Practice Address - Street 2:
Practice Address - City:ALTADENA
Practice Address - State:CA
Practice Address - Zip Code:91001-1932
Practice Address - Country:US
Practice Address - Phone:323-443-3279
Practice Address - Fax:323-443-3267
Is Sole Proprietor?:No
Enumeration Date:2007-03-21
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAVN126756164X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164X00000XNursing Service ProvidersLicensed Vocational Nurse