Individual
JUAN CARLOS VAZQUEZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
NAVY IDC
Contact information
Practice address
3936 BAJA VISTA DR, OCEANSIDE, CA 92058-7973
(858) 539-6223
Mailing address
3936 BAJA VISTA DR, OCEANSIDE, CA 92058-7973
(858) 539-6223
Taxonomy
Speciality
Code
Description
License number
State
1710I1002X
Independent Duty Corpsman
Primary
—
—
Other
Enumeration date
02/25/2008
Last updated
02/25/2008
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