Individual
TARA M VIECHNICKI
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
477 N EL CAMINO REAL STE C202, ENCINITAS, CA 92024-1332
(760) 631-3500
Mailing address
477 N EL CAMINO REAL, STE C202, ENCINITAS, CA 92024-1332
(760) 631-3500
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
0101243689
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1235156837
—
VA
Enumeration date
07/17/2006
Last updated
12/02/2020
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