Individual
DR. JOSE LUIS VEGA III
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
675 S AVENUE B, YUMA, AZ 85364-2749
(928) 539-3140
(928) 782-5296
Mailing address
2060 W 24TH ST, YUMA, AZ 85364-6123
(928) 819-8834
(928) 539-5579
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
54496
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
303915
—
AZ
Enumeration date
06/04/2012
Last updated
02/14/2019
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