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Individual

MR. OSCAR VIVANCO JR.

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
R.N.

Contact information

Practice address
39500 LIBERTY ST, FREMONT, CA 94530
(510) 770-8133
(510) 770-8140
Mailing address
39500 LIBERTY ST, FREMONT, CA 94530
(510) 770-8133
(510) 770-8140

Taxonomy

Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
731612
CA
163WC1500X
Community Health Registered Nurse
Primary
731612
CA

Other

Enumeration date
09/10/2008
Last updated
09/10/2008
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