Basic Information
| Provider Information | |||||||||
| NPI: | 1063691061 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | VINZON | ||||||||
| FirstName: | RIZA | ||||||||
| MiddleName: | ALMA | ||||||||
| NamePrefix: | MS. | ||||||||
| NameSuffix: | |||||||||
| Credential: | NP | ||||||||
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| Mailing Information | |||||||||
| Address1: | 4401 ATLANTIC AVE STE 202 | ||||||||
| Address2: | |||||||||
| City: | LONG BEACH | ||||||||
| State: | CA | ||||||||
| PostalCode: | 908072252 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5629882777 | ||||||||
| FaxNumber: | 5629882779 | ||||||||
| Practice Location | |||||||||
| Address1: | 4401 ATLANTIC AVE STE 202 | ||||||||
| Address2: | |||||||||
| City: | LONG BEACH | ||||||||
| State: | CA | ||||||||
| PostalCode: | 90807 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5629882777 | ||||||||
| FaxNumber: | 5629882779 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 10/26/2007 | ||||||||
| LastUpdateDate: | 10/21/2018 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 363LA2200X | 314610 | CA | Y | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Adult Health |
No ID Information.