Individual
JAIME VASQUEZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
401 BICENTENNIAL WAY, SANTA ROSA, CA 95403-2149
(707) 393-4000
Mailing address
1091 BOYLSTON ST, APT 23, BOSTON, MA 02215-3656
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
A116567
CA
207R00000X
Internal Medicine Physician
233481
MA
Other
Enumeration date
04/28/2008
Last updated
02/11/2022
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