Provider Demographics
NPI:1922087253
Name:BAZA-VARGAS, ARMANDO (PA-C)
Entity Type:Individual
Prefix:MR
First Name:ARMANDO
Middle Name:
Last Name:BAZA-VARGAS
Suffix:
Gender:M
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:969 S SANTA FE AVE STE A
Mailing Address - Street 2:
Mailing Address - City:VISTA
Mailing Address - State:CA
Mailing Address - Zip Code:92083-6910
Mailing Address - Country:US
Mailing Address - Phone:760-941-7050
Mailing Address - Fax:760-941-7142
Practice Address - Street 1:969 S SANTA FE AVE STE A
Practice Address - Street 2:
Practice Address - City:VISTA
Practice Address - State:CA
Practice Address - Zip Code:92083-6910
Practice Address - Country:US
Practice Address - Phone:760-941-7050
Practice Address - Fax:760-941-7142
Is Sole Proprietor?:No
Enumeration Date:2006-01-13
Last Update Date:2019-12-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPA17924363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical