Vicencio, Eduardita Eolani

Vicencio, Eduardita Eolani is an sole proprietor health care provider with primary practice located at 16031 Tuscola Rd , Apple Valley CA 92307-1319. She recently has only one registered license in Allopathic & Osteopathic Physicians / Ophthalmology, which is considered as her primary health care specialty. Vicencio, Eduardita Eolani can be contacted via phone (760) 946-2020.

Contact Information

Primary practice address
16031 Tuscola Rd Apple Valley CA 92307-1319
Phone: (760) 946-2020
Fax:
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Ophthalmology 207W00000X A23710 California

Profile Details

NPI number 1790903573
LBN Legal business name Vicencio, Eduardita Eolani
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Apr 24th, 2007
Last updated Oct 6th, 2014 - about 12 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1790903573 NPPES
California MEDICAID 00A237100

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