Individual
DR. WALTER DAVID VAZQUEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
34800 BOB WILSON DR, PEDIATRIC SURGERY CLINIC, SAN DIEGO, CA 92134-1098
(619) 532-5953
Mailing address
877 ISLAND AVE, #416, SAN DIEGO, CA 92101-7116
(619) 795-0988
Taxonomy
Speciality
Code
Description
License number
State
2086S0120X
Pediatric Surgery Physician
Primary
G83488
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00G834880
—
CA
Enumeration date
02/06/2006
Last updated
11/29/2021
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