Vast Oceanside Elderly Care

Primary specialty

PACE Provider OrganizationTaxonomy code 251T00000X

License

374603403 Issued in CA

Legal business name

VAST OCEANSIDE ELDERLY CARE

Practice address

452 Foussat Rd
Oceanside, CA 92054-4709

Phone

(760) 529-9257

Fax

(760) 529-9257

NPI assigned

Nov 30, 2017

Organization subpart

No

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

Authorized official

Name

Mr. Daniel Leavitt

Title

Administrator

Phone

(760) 807-8585

Specialties & licenses 1

Addresses

Other identifiers 1

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

{
    "created_epoch": "1512000000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1512000000000",
    "number": "1669986410",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "452 FOUSSAT RD",
            "city": "OCEANSIDE",
            "state": "CA",
            "postal_code": "920544709",
            "telephone_number": "760-529-9257",
            "fax_number": "760-529-9257"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "452 FOUSSAT RD",
            "city": "OCEANSIDE",
            "state": "CA",
            "postal_code": "920544709",
            "telephone_number": "760-529-9257",
            "fax_number": "760-529-9257"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VAST OCEANSIDE ELDERLY CARE",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-11-30",
        "last_updated": "2017-11-30",
        "status": "A",
        "authorized_official_last_name": "LEAVITT",
        "authorized_official_first_name": "DANIEL",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "760-807-8585",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "251T00000X",
            "taxonomy_group": "",
            "desc": "Program of All-Inclusive Care for the Elderly (PACE) Provider Organization",
            "state": "CA",
            "license": "374603403",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CDSS",
            "identifier": "374603403",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Vasquez Dental Corporation
• Daniel Vasquez, DDS
• Fabio Vasquez, MD
• Jose Angelo Ragon Vasquez, D.D.S.
• Julie Vasquez
• Pratan Vathesatogkit, M.D.
• Clayton Vaughan, M.D.
• Aaron Vaughn
• Claudette Vaughn, RD
• Lorenia Lucia Vaughn, D.D.S.

• PACE Provider Organization in Oceanside, CA
• Providers in Oceanside, CA by specialty
• PACE Provider Organization in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 30, 2017; 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.