| Doctor Name: | JOSE VELASQUEZ DE JESUS |
| NPI Number: | 1295837532 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | MD |
| License Number: | A42214 |
| Business Practice Address: | 2947 Sierra Way Rosamond, CA - 93560 |
| Business Phone Number: | 6612561219 |
| Business Fax Number: | 6612562494 |
| Mailing Address: | 868 West Avenue J, LANCASTER |
| State: | CA |
| Postal Code: | 93534 |
| Phone Number: | 6619452222 |
| Fax Number: | 6619407062 |
| NPI Enumeration Date: | 09/05/2006 |
| NPI Last Update Date: | 07/08/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 261QM2500X |
| License Number: | A42214 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | CA |
| Taxonomy Type: | Ambulatory Health Care Facilities |
| Taxonomy Classification: | Clinic/Center |
| Taxonomy Specialization: | Medical Specialty |
| Taxonomy Definition: | An entity, facility, or distinct part of a facility providing diagnostic, treatment, and prescriptive services related to a specific area of medical specialization. Frequently used for Title V related Children's Specialty services or to meet specific public health needs (e.g., infectious diseases or breast and cervical cancer). |