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Individual

ISAIAS RODOLFO VARGAS JR.

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
CRNP

Contact information

Practice address
16850 BEAR VALLEY RD, VICTORVILLE, CA 92395-5795
(760) 241-8000
Mailing address
PO BOX 1786, RANCHO CUCAMONGA, CA 91729-1786
(702) 675-0557

Taxonomy

Speciality
Code
Description
License number
State
363LG0600X
Gerontology Nurse Practitioner
Primary
NP95011154
CA
363LG0600X
Gerontology Nurse Practitioner
SP018742
PA

Other

Enumeration date
05/18/2018
Last updated
06/20/2023
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