Individual
CARLOS ALBERTO VAQUERO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
9375 SAN FERNANDO RD, SUN VALLEY, CA 91352-1428
(818) 768-3000
(818) 504-4690
Mailing address
9375 SAN FERNANDO RD, SUN VALLEY, CA 91352-1418
(818) 768-3000
(818) 797-7178
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
A-180694
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
A-180694
CALIFORNIA MEDICAL LICENSE
CA
Enumeration date
04/18/2019
Last updated
08/23/2022
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