Provider Demographics
NPI:1407882863
Name:VECCHI, NICOLE THANH - CAM (MD)
Entity Type:Individual
Prefix:
First Name:NICOLE
Middle Name:THANH - CAM
Last Name:VECCHI
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:429 S MAIN ST
Mailing Address - Street 2:
Mailing Address - City:MILPITAS
Mailing Address - State:CA
Mailing Address - Zip Code:95035-5318
Mailing Address - Country:US
Mailing Address - Phone:408-935-9586
Mailing Address - Fax:408-719-1979
Practice Address - Street 1:429 S MAIN ST
Practice Address - Street 2:
Practice Address - City:MILPITAS
Practice Address - State:CA
Practice Address - Zip Code:95035-5318
Practice Address - Country:US
Practice Address - Phone:408-935-9586
Practice Address - Fax:408-719-1979
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-25
Last Update Date:2020-02-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG835610174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist