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Specialty details in registry · Vista, CA

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At a glance

411 Dennis Dr, Vista, CA 92083-7776

NPPES record updated Feb 6, 2008. Public records can lag behind changes at a practice.

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Practice location

411 Dennis Dr
Vista, CA 92083-7776

Professional details: NPI, taxonomy & registry record

NPI1760660336

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Registry details

Primary taxonomy: Specialty details in registry
Taxonomy code: 315P00000X
Enumeration date: Feb 6, 2008
Record updated: Feb 6, 2008

More registry details

Provider type: Organization · Type 2

Reported taxonomies and licenses

Specialty details in registry

315P00000X · Primary

License reported: LTC80409F CA

License numbers and credentials are reported to NPPES; HCPList does not independently verify them.

Practice location

411 Dennis Dr
Vista, CA 92083-7776

Phone: (760) 842-5147
Fax: (760) 842-5148

Mailing address

411 DENNIS DR

VISTA, CA 920837776

Source: NPPES Source through Oct 18, 2026An NPI does not verify licensure or credentials.

Information may be outdated or incomplete. Confirm details directly with the practice. HCPList is an independent directory and is not affiliated with CMS.

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