Individual
MR. CARLOS VASQUEZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PA
Contact information
Practice address
4067 TWEEDY BLVD, SOUTH GATE, CA 90280-6146
(323) 569-1126
(877) 403-7113
Mailing address
4067 TWEEDY BLVD, SOUTH GATE, CA 90280-6146
(323) 569-1126
(877) 403-7113
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA14141
CA
363AS0400X
Surgical Physician Assistant
Primary
PA14141
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
PA14141
PA LICENSE
CA
Enumeration date
10/26/2007
Last updated
03/18/2026
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