Most Relevant Information
Provider Data
| NPI Number: | 1003077793 |
| Provider Name: | IRENE E. VEGA RN, PHN |
| Entity Type: | Individual |
| Taxonomy Code: | 163WA2000X |
| Specialty: | Registered Nurse |
| License Number: | RN182833 |
Most Important Dates
| Enumeration Date: | 06/24/2008 |
| Last Updated: | 06/24/2008 |
Provider Practice Location
2191 JOHNSON AVE
SAN LUIS OBISPO
CA
934014534
Practice Location Phone/Fax
| Phone: | 8057815535 |
| Fax: | 8057811372 |
Provider Mailing Location
2623 BRENTWOOD CIR
ARROYO GRANDE
CA
934206505
Provider Mailing Phone/Fax
| Phone: | 8057815535 |
| Fax: | 8057811372 |