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Individual

DR. THOMAS HENRY VINCENT II

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
D.P.M.

Contact information

Practice address
620 W TEFFT ST, NIPOMO, CA 93444-9187
(805) 929-8055
(805) 929-8066
Mailing address
620 W TEFFT ST, NIPOMO, CA 93444-9187
(805) 929-8055
(805) 929-8066

Taxonomy

Speciality
Code
Description
License number
State
213E00000X
Podiatrist
E3864
CA
213ES0103X
Foot & Ankle Surgery Podiatrist
Primary
E3864
CA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
000E38640
CA
01
480015952
RAILROAD MEDICARE
CA
01
RHC140373
RADIOGRAPHY
CA
Enumeration date
06/27/2006
Last updated
03/07/2023
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