VITALITY MEDICAL CENTER INC NPI 1184198442

NPI Information

VITALITY MEDICAL CENTER INC is a general practice in Glendale, CA. VITALITY MEDICAL CENTER INC NPI is 1184198442. The provider is registered as an organization entity type and is a multi-specialty group.

The provider's business location address is:

1648 W GLENOAKS BLVD # 101
GLENDALE, CA
ZIP 91201-827
Phone: (818) 805-0005
Fax: (818) 805-0050

The provider's authorized official is Lilia Serobian .
The authorized official title is Secretary and has the following contact phone number (818) 805-0005.

The CLIA number assigned to this NPI record is 05D2167328 - other practitioner with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 1/18/2019 and was last updated on 1/18/2019.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

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