Provider Demographics
NPI:1437227568
Name:VEGA, JULIO C (MD)
Entity Type:Individual
Prefix:DR
First Name:JULIO
Middle Name:C
Last Name:VEGA
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Gender:M
Credentials:MD
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Mailing Address - Street 1:11160 WARNER AVE
Mailing Address - Street 2:119
Mailing Address - City:FOUNTAIN VALLEY
Mailing Address - State:CA
Mailing Address - Zip Code:92708-4008
Mailing Address - Country:US
Mailing Address - Phone:714-850-1872
Mailing Address - Fax:714-850-1874
Practice Address - Street 1:11160 WARNER AVE
Practice Address - Street 2:119
Practice Address - City:FOUNTAIN VALLEY
Practice Address - State:CA
Practice Address - Zip Code:92708-4008
Practice Address - Country:US
Practice Address - Phone:714-850-1872
Practice Address - Fax:714-850-1874
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-30
Last Update Date:2007-07-09
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Provider Licenses
StateLicense IDTaxonomies
CAA33429208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAA33429AMedicare UPIN