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1234 N Santa Fe Ave Suite 114 Vista CA 92083-3206 | |
| (760) 732-5878 | |
| (760) 732-5939 |
| Full Name | |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 1234 N Santa Fe Ave, Vista, California |
| Authorized Official Name and Position | Vinh Bao Le (OWNER) |
| Authorized Official Contact | 7607325878 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
1234 N Santa Fe Ave Suite 114 Vista CA 92083-3206 Ph: (760) 732-5878 | 1234 N Santa Fe Ave Suite 114 Vista CA 92083-3206 Ph: (760) 732-5878 |
| NPI Number | 1447284310 |
|---|---|
| Provider Enumeration Date | 07/10/2006 |
| Last Update Date | 06/22/2024 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1447284310 | NPI | - | NPPES |
| G89747-01 | Medicaid | CA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | (* (Not Available)) | Primary |
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