Provider Demographics
NPI:1992438444
Name:VARGAS, OSCAR ADAN
Entity type:Individual
Prefix:
First Name:OSCAR
Middle Name:ADAN
Last Name:VARGAS
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9538 VICTORIA AVE APT G
Mailing Address - Street 2:
Mailing Address - City:SOUTH GATE
Mailing Address - State:CA
Mailing Address - Zip Code:90280-4462
Mailing Address - Country:US
Mailing Address - Phone:323-241-7146
Mailing Address - Fax:
Practice Address - Street 1:9538 VICTORIA AVE APT G
Practice Address - Street 2:
Practice Address - City:SOUTH GATE
Practice Address - State:CA
Practice Address - Zip Code:90280-4462
Practice Address - Country:US
Practice Address - Phone:323-241-7146
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-07-01
Last Update Date:2022-07-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician