Healthcare Provider Details

I. General information

NPI: 1659127454
Provider Name (Legal Business Name): VIPEAK PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/24/2024
Last Update Date: 11/25/2024
Certification Date: 11/25/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

131 ORANGE AVE # 100
CORONADO CA
92118-1408
US

IV. Provider business mailing address

131 ORANGE AVE # 100
CORONADO CA
92118-1408
US

V. Phone/Fax

Practice location:
  • Phone: 619-522-4005
  • Fax: 619-522-4014
Mailing address:
  • Phone: 619-522-4005
  • Fax: 619-522-4014

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207QA0505X
TaxonomyAdult Medicine Physician
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code261Q00000X
TaxonomyClinic/Center
License Number
License Number State

VIII. Authorized Official

Name: DR. PATRICK YASSINI
Title or Position: OWNER
Credential: MD
Phone: 619-522-4005