Provider Demographics
NPI:1710926282
Name:VARGAS, MICHAEL JOSEPH (MD)
Entity Type:Individual
Prefix:
First Name:MICHAEL
Middle Name:JOSEPH
Last Name:VARGAS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1545 W FLORIDA AVE
Mailing Address - Street 2:
Mailing Address - City:HEMET
Mailing Address - State:CA
Mailing Address - Zip Code:92543-3814
Mailing Address - Country:US
Mailing Address - Phone:951-791-1111
Mailing Address - Fax:888-856-3893
Practice Address - Street 1:27555 YNEZ RD
Practice Address - Street 2:#400
Practice Address - City:TEMECULA
Practice Address - State:CA
Practice Address - Zip Code:92591-4687
Practice Address - Country:US
Practice Address - Phone:951-693-4433
Practice Address - Fax:888-518-0564
Is Sole Proprietor?:No
Enumeration Date:2006-06-06
Last Update Date:2022-04-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA32208207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAA26730Medicare UPIN
CA00A322080Medicare ID - Type UnspecifiedMEDICARE