Provider Demographics
NPI:1821347576
Name:VARGO, JAMES B III (MPT)
Entity Type:Individual
Prefix:
First Name:JAMES
Middle Name:B
Last Name:VARGO
Suffix:III
Gender:M
Credentials:MPT
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Mailing Address - Street 1:27125 SIERRA HWY
Mailing Address - Street 2:STE 203
Mailing Address - City:CANYON COUNTRY
Mailing Address - State:CA
Mailing Address - Zip Code:91351-5428
Mailing Address - Country:US
Mailing Address - Phone:661-250-9940
Mailing Address - Fax:661-250-9959
Practice Address - Street 1:4211 TIERRA REJADA RD
Practice Address - Street 2:
Practice Address - City:MOORPARK
Practice Address - State:CA
Practice Address - Zip Code:93021-3772
Practice Address - Country:US
Practice Address - Phone:805-523-8076
Practice Address - Fax:805-523-8796
Is Sole Proprietor?:No
Enumeration Date:2012-09-07
Last Update Date:2012-09-07
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CAPT39166225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist