Organization
CARLOS R. VIGIL, D.O. (A PROFESSIONAL CORPORATION)
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SUSAN VIGIL (MANAGER)
(909) 941-0661
Entity
Organization
Contact information
Practice address
7974 HAVEN AVE, SUITE 210, RANCHO CUCAMONGA, CA 91730-3052
(909) 941-0661
(909) 948-5577
Mailing address
7974 HAVEN AVE, SUITE 210, RANCHO CUCAMONGA, CA 91730-3052
(909) 941-0661
(909) 948-5577
Taxonomy
Speciality
Code
Description
License number
State
261QP2300X
Primary Care Clinic/Center
Primary
20A7446
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00AX74460
—
CA
Enumeration date
01/08/2009
Last updated
01/08/2009
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