Individual
JOSE MANUEL JIMENEZ VEGA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
9680 TAMARACK RD STE 130, WOODBURY, MN 55125-2623
(651) 265-7575
(651) 265-7580
Mailing address
9680 TAMARACK RD STE 130, WOODBURY, MN 55125-2623
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
70530
MN
2080P0205X
Pediatric Endocrinology Physician
4301108745
MI
2080P0205X
Pediatric Endocrinology Physician
Primary
70530
MN
Other
Enumeration date
01/26/2010
Last updated
11/04/2024
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