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Individual

WILFREDO ANTONIO VELASCO VARGAS

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
RN

Contact information

Practice address
6041 CADILLAC AVE, LOS ANGELES, CA 90034-1702
(562) 373-5022
Mailing address
74 CALLE SANTA CRUZ APT PHG, BAYAMON, PR 00961-7083
(310) 906-7434

Taxonomy

Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
099694
PR
163W00000X
Registered Nurse
246957
TN
163W00000X
Registered Nurse
95042984
CA
367500000X
Certified Registered Nurse Anesthetist
Primary
NA95002659
CA

Other

Enumeration date
09/25/2020
Last updated
08/20/2025
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