Healthcare Provider Details

I. General information

NPI: 1194189779
Provider Name (Legal Business Name): VIGILANT CARE INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/08/2016
Last Update Date: 04/08/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

131 E HUNTINGTON DR
ARCADIA CA
91006-3212
US

IV. Provider business mailing address

5 HOLLAND SUITE 101
IRVINE CA
92618-2566
US

V. Phone/Fax

Practice location:
  • Phone: 626-445-0326
  • Fax:
Mailing address:
  • Phone: 949-588-2190
  • Fax: 949-588-2199

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License Number
License Number State

VIII. Authorized Official

Name: JOHN P SALAPATE
Title or Position: PRESIDENT
Credential: CRNA
Phone: 469-438-4116