Provider Demographics
NPI:1912630856
Name:VARGAS TORRES, MARIA LUISA (MD)
Entity Type:Individual
Prefix:DR
First Name:MARIA
Middle Name:LUISA
Last Name:VARGAS TORRES
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:351 FELICE DR
Mailing Address - Street 2:
Mailing Address - City:HOLLISTER
Mailing Address - State:CA
Mailing Address - Zip Code:95023-3361
Mailing Address - Country:US
Mailing Address - Phone:831-634-2123
Mailing Address - Fax:
Practice Address - Street 1:351 FELICE DR
Practice Address - Street 2:
Practice Address - City:HOLLISTER
Practice Address - State:CA
Practice Address - Zip Code:95023-3361
Practice Address - Country:US
Practice Address - Phone:831-634-2123
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-07-07
Last Update Date:2022-07-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAP17207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine