Individual
JUAN ANGEL VASQUEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
523 ROSE LN, WICKENBURG, AZ 85390-1448
(286) 668-1833
Mailing address
523 ROSE LN, WICKENBURG, AZ 85390-1448
(928) 668-1833
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
47893
WI
207R00000X
Internal Medicine Physician
Primary
57599
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
34637900
—
WI
01
—
P00280478
RAILROAD MEDICARE
WI
Enumeration date
11/22/2005
Last updated
06/23/2021
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