Provider Demographics
NPI:1083978209
Name:TES, VIBOLL SEY (RDCS)
Entity Type:Individual
Prefix:MR
First Name:VIBOLL
Middle Name:SEY
Last Name:TES
Suffix:
Gender:M
Credentials:RDCS
Other - Prefix:
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Other - Middle Name:
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Other - Credentials:
Mailing Address - Street 1:305 N MARGUERITA AVE
Mailing Address - Street 2:APT 20
Mailing Address - City:ALHAMBRA
Mailing Address - State:CA
Mailing Address - Zip Code:91801-2178
Mailing Address - Country:US
Mailing Address - Phone:626-232-9638
Mailing Address - Fax:
Practice Address - Street 1:305 N MARGUERITA AVE
Practice Address - Street 2:APT 20
Practice Address - City:ALHAMBRA
Practice Address - State:CA
Practice Address - Zip Code:91801-2178
Practice Address - Country:US
Practice Address - Phone:626-232-9638
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-07-02
Last Update Date:2012-07-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA146270246XS1301X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes246XS1301XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist CardiovascularSonography