Healthcare Provider Details
I. General information
NPI: 1124395322
Provider Name (Legal Business Name): VIMA MEDICAL, INC., A PROFESSION CORPORATION
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 11/17/2011
Last Update Date: 03/01/2012
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
9001 WILSHIRE BLVD STE 106
BEVERLY HILLS CA
90211-1839
US
IV. Provider business mailing address
8581 SANTA MONICA BLVD # 978
WEST HOLLYWOOD CA
90069-4120
US
V. Phone/Fax
- Phone: 310-230-5741
- Fax:
- Phone:
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207QS1201X |
| Taxonomy | Sleep Medicine (Family Medicine) Physician |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
ELLIOT
ALPERT
Title or Position: PRESIDENT
Credential:
Phone: 310-230-5741