Provider Demographics
NPI:1992419162
Name:VARGAS TON, JOSE (LAC)
Entity type:Individual
Prefix:
First Name:JOSE
Middle Name:
Last Name:VARGAS TON
Suffix:
Gender:M
Credentials:LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 6610
Mailing Address - Street 2:
Mailing Address - City:CHANDLER
Mailing Address - State:AZ
Mailing Address - Zip Code:85246-6610
Mailing Address - Country:US
Mailing Address - Phone:480-926-7800
Mailing Address - Fax:
Practice Address - Street 1:1949 W RAY RD STE 23
Practice Address - Street 2:
Practice Address - City:CHANDLER
Practice Address - State:AZ
Practice Address - Zip Code:85224-4008
Practice Address - Country:US
Practice Address - Phone:480-926-7800
Practice Address - Fax:480-926-2260
Is Sole Proprietor?:No
Enumeration Date:2023-01-11
Last Update Date:2023-01-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZLAC011363171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist