Marco Vinicio Vasquez

Primary specialty

Registered DietitianTaxonomy code 133V00000X

License

951991 Issued in CA

Practice address

15262 River Rock Dr
Fontana, CA 92336

Phone

(909) 689-5065

NPI assigned

Jun 20, 2012

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1340150400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1340150400000",
    "number": "1902169451",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15262 RIVER ROCK DR",
            "city": "FONTANA",
            "state": "CA",
            "postal_code": "923365344",
            "telephone_number": "909-689-5065"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15262 RIVER ROCK DR",
            "city": "FONTANA",
            "state": "CA",
            "postal_code": "92336",
            "telephone_number": "909-689-5065"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VASQUEZ",
        "first_name": "MARCO",
        "middle_name": "VINICIO",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2012-06-20",
        "last_updated": "2012-06-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "CA",
            "license": "951991",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Susan K Varghese, MD
• Varity Healthcare
• Miten Vasa, M.D.
• Jonathan Michael Vasquez, MS
• Julie Margarita Vasquez
• Nicole Diane Vasquez, DO
• Prasit B. Vassantachart, MD
• Demetra Vaughan
• Priscilla S Vaughn, FNP
• Neal Vavra, DDS

• Registered Dietitian in Fontana, CA
• Providers in Fontana, CA by specialty
• Registered Dietitian in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 20, 2012; 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.