Newly enumerated
The official enumeration date falls within the documented new-enumeration window.
- Enumeration date is 18 days before observation
Type 2 organization · NPI 1770400202
VET PHOENIX
251B00000X · MORENO VALLEY, CA
Why this profile is appearing now
Observed change signals
Reported classification
Taxonomies
| Code | Description | Source flag |
|---|---|---|
| 251B00000X | 251B00000X | Primary |
| 177F00000X | 177F00000X | Additional |
| 251V00000X | 251V00000X | Additional |
Taxonomy reporting does not establish licensure, board certification, expertise, or quality.
Longitudinal record
Observed change timeline
- 0 recorded field change s