Individual
JAMES VANDERBILT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
11153 LUKE ST, FORT BLISS, TX 79918-8010
(714) 369-4727
Mailing address
333 W BROADWAY UNIT 1896, ANAHEIM, CA 92815-2088
(171) 436-9472
Taxonomy
Speciality
Code
Description
License number
State
163WM0705X
Medical-Surgical Registered Nurse
Primary
723689
CA
Other
Enumeration date
05/15/2023
Last updated
05/15/2023
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