Provider Demographics
NPI:1164861456
Name:VARGAS, JENNIFER VEGA (MD)
Entity Type:Individual
Prefix:DR
First Name:JENNIFER
Middle Name:VEGA
Last Name:VARGAS
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:26520 CACTUS AVE
Mailing Address - Street 2:FAMILY MEDICINE DEPARTMENT
Mailing Address - City:MORENO VALLEY
Mailing Address - State:CA
Mailing Address - Zip Code:92555-3927
Mailing Address - Country:US
Mailing Address - Phone:951-486-5611
Mailing Address - Fax:951-486-5620
Practice Address - Street 1:26520 CACTUS AVE
Practice Address - Street 2:FAMILY MEDICINE CLINIC
Practice Address - City:MORENO VALLEY
Practice Address - State:CA
Practice Address - Zip Code:92555-3927
Practice Address - Country:US
Practice Address - Phone:951-486-5593
Practice Address - Fax:951-486-5595
Is Sole Proprietor?:Yes
Enumeration Date:2013-06-19
Last Update Date:2021-10-27
Deactivation Date:
Deactivation Code:
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Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program