Basic Information
| Provider Information | |||||||||
| NPI: | 1811196470 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | VARGAS | ||||||||
| FirstName: | MOISES | ||||||||
| MiddleName: | |||||||||
| NamePrefix: | DR. | ||||||||
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| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 219 N INDIAN HILL BLVD | ||||||||
| Address2: | SUITE 202 B | ||||||||
| City: | CLAREMONT | ||||||||
| State: | CA | ||||||||
| PostalCode: | 917114644 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3102288772 | ||||||||
| FaxNumber: | 6268577275 | ||||||||
| Practice Location | |||||||||
| Address1: | 219 N INDIAN HILL BLVD | ||||||||
| Address2: | SUITE 202 B | ||||||||
| City: | CLAREMONT | ||||||||
| State: | CA | ||||||||
| PostalCode: | 917114644 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3102288772 | ||||||||
| FaxNumber: | 6268577275 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 07/13/2007 | ||||||||
| LastUpdateDate: | 05/16/2013 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 2084P0804X | A88581 | CA | N | Allopathic & Osteopathic Physicians | Psychiatry & Neurology | Child & Adolescent Psychiatry | 2084B0040X | A88581 | CA | N | Allopathic & Osteopathic Physicians | Psychiatry & Neurology | Behavioral Neurology & Neuropsychiatry | 2084P0802X | A88581 | CA | N | Allopathic & Osteopathic Physicians | Psychiatry & Neurology | Addiction Psychiatry | 2084P0800X | A88581 | CA | Y | Allopathic & Osteopathic Physicians | Psychiatry & Neurology | Psychiatry |
No ID Information.