Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2086X0206X | Surgical Oncologist | A65735 | CA |
NPI | 1083745491 |
---|---|
Provider Name | Julio E Vaquerano |
First Address | Modesto, CA 95357-7680 |
Second Address | Stockton, CA 95210-3377 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 08/03/2007 |
Last Update Date | 29/11/2021 |