Provider Demographics
NPI:1740233493
Name:VARDAYO, JOSEPH FAMIL (MD FACS)
Entity Type:Individual
Prefix:DR
First Name:JOSEPH
Middle Name:FAMIL
Last Name:VARDAYO
Suffix:
Gender:M
Credentials:MD FACS
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:701 EAST 28TH ST
Mailing Address - Street 2:SUITE 314
Mailing Address - City:LONG BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:90806
Mailing Address - Country:US
Mailing Address - Phone:562-981-9308
Mailing Address - Fax:562-981-9318
Practice Address - Street 1:701 EAST 28TH ST
Practice Address - Street 2:SUITE 314
Practice Address - City:LONG BEACH
Practice Address - State:CA
Practice Address - Zip Code:90806
Practice Address - Country:US
Practice Address - Phone:562-981-9308
Practice Address - Fax:562-981-9318
Is Sole Proprietor?:No
Enumeration Date:2006-05-17
Last Update Date:2016-06-27
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CAA43961208600000X, 2086S0129X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2086S0129XAllopathic & Osteopathic PhysiciansSurgeryVascular Surgery
No208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00A439610Medicaid
CAGR0046780Medicare ID - Type Unspecified
CA00A439610Medicaid