Organization Active NPI

Miguel Vasquez MD Ann Carroll MD a Prof Corp

  • Internal Medicine Physician
  • Freedom, CA
National Provider Identifier
1629136965
Registry record updated Sep 11, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
G38080 Issued in CA
Legal business name
MIGUEL VASQUEZ MD ANN CARROLL MD A PROF CORP
Practice address
243 Green Valley Rd
Suite a
Freedom, CA 95019
Phone
(831) 728-4595
Fax
(831) 728-4598
NPI assigned
Dec 5, 2006
Last updated
Sep 11, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 11, 2025

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Miguel Vasquez, MDNPI 1255447041
Title
President
Phone
(831) 728-4595

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207R00000X G38080 CA Primary
Cardiovascular Disease PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207RC0000X A33076 CA

Addresses

Primary practice location

243 Green Valley Rd
Suite a
Freedom, CA 95019

Mailing address

243 Green Valley Rd
Suite a
Freedom, CA 95019

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1165276800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1757548800000",
    "number": "1629136965",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "243 GREEN VALLEY RD",
            "address_2": "SUITE A",
            "city": "FREEDOM",
            "state": "CA",
            "postal_code": "95019"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "243 GREEN VALLEY RD",
            "address_2": "SUITE A",
            "city": "FREEDOM",
            "state": "CA",
            "postal_code": "95019",
            "telephone_number": "831-728-4595",
            "fax_number": "831-728-4598"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MIGUEL VASQUEZ MD ANN CARROLL MD A PROF CORP",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-05",
        "last_updated": "2025-09-11",
        "status": "A",
        "authorized_official_last_name": "VASQUEZ",
        "authorized_official_first_name": "MIGUEL",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "831-728-4595",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": "CA",
            "license": "G38080",
            "primary": true
        },
        {
            "code": "207RC0000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "CA",
            "license": "A33076",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Freedom, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 11, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.