Provider Demographics
NPI:1740217561
Name:VELA, MARIO R (AT,C)
Entity Type:Individual
Prefix:MR
First Name:MARIO
Middle Name:R
Last Name:VELA
Suffix:
Gender:M
Credentials:AT,C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Mailing Address - Street 1:199 DELANEY DR
Mailing Address - Street 2:
Mailing Address - City:CHICO
Mailing Address - State:CA
Mailing Address - Zip Code:95928-3838
Mailing Address - Country:US
Mailing Address - Phone:530-895-2370
Mailing Address - Fax:530-895-2260
Practice Address - Street 1:3536 BUTTE CAMPUS DR
Practice Address - Street 2:
Practice Address - City:OROVILLE
Practice Address - State:CA
Practice Address - Zip Code:95965-8303
Practice Address - Country:US
Practice Address - Phone:530-895-2370
Practice Address - Fax:530-895-2260
Is Sole Proprietor?:No
Enumeration Date:2006-06-27
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer