Healthcare Provider Details

I. General information

NPI: 1821976515
Provider Name (Legal Business Name): VINCENT ZITO
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/22/2025
Last Update Date: 12/02/2025
Certification Date: 12/02/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

631 S BROOKHURST ST STE 213B
ANAHEIM CA
92804-3558
US

IV. Provider business mailing address

10583 EL ESTE AVE
FOUNTAIN VALLEY CA
92708-6007
US

V. Phone/Fax

Practice location:
  • Phone: 714-831-1450
  • Fax:
Mailing address:
  • Phone: 714-862-8160
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: