Individual
LEAH M VERGARA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
11160 WARNER AVE STE 311, FOUNTAIN VALLEY, CA 92708-4055
(714) 850-7300
(714) 850-7310
Mailing address
PO BOX 15848, NEWPORT BEACH, CA 92659-5848
(657) 241-3600
(657) 241-7708
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
51680
CA
363AS0400X
Surgical Physician Assistant
Primary
51680
CA
Other
Enumeration date
08/12/2014
Last updated
09/10/2019
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