Individual
JERRY CHARLES VEGA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
66675 PIERSON BLVD, DESERT HOT SPRINGS, CA 92240-3737
(760) 676-5240
Mailing address
1515 E CEDAR AVE STE A-3, FLAGSTAFF, AZ 86004-1630
(928) 774-2788
(928) 774-0123
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
7657
AZ
363AM0700X
Medical Physician Assistant
Primary
59492
CA
Other
Enumeration date
09/21/2019
Last updated
06/17/2021
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