Individual
ABRAHAM ALEJANDRO VANDIVER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
FNP
Contact information
Practice address
488 E VALLEY PKWY STE 411, ESCONDIDO, CA 92025-3380
(833) 867-4642
(360) 462-2741
Mailing address
1234 RIVERVIEW AVE, EL CENTRO, CA 92243-9109
(760) 960-2663
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
820909
CA
363LF0000X
Family Nurse Practitioner
Primary
95011167
CA
Other
Enumeration date
12/31/2018
Last updated
02/12/2025
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