Individual
VICENTE REY ADEFUIN TEJADA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
NP
Contact information
Practice address
231 BRISA DEL MAR, LOMPOC, CA 93436-2611
(805) 757-1987
Mailing address
231 BRISA DEL MAR, LOMPOC, CA 93436-2611
(805) 757-1987
Taxonomy
Speciality
Code
Description
License number
State
363LP2300X
Primary Care Nurse Practitioner
Primary
23034
CA
Other
Enumeration date
07/23/2015
Last updated
07/23/2015
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