Individual
ALFREDO VERGARA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
1968 W ADAMS BLVD # 106, LOS ANGELES, CA 90018-3515
(323) 731-3534
(323) 731-5618
Mailing address
515 COLUMBIA AVE # 200, LOS ANGELES, CA 90017-1209
(213) 249-9388
(213) 389-7993
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
—
172A00000X
Driver
B4629156
CA
Other
Enumeration date
10/07/2020
Last updated
03/12/2021
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