Healthcare Provider Details

I. General information

NPI: 1831895960
Provider Name (Legal Business Name): MINDAUGAS VIELA M.D. INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/31/2023
Last Update Date: 02/02/2023
Certification Date: 02/02/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1500 E CHEVY CHASE DR STE 450
GLENDALE CA
91206-4153
US

IV. Provider business mailing address

PO BOX 5486
ORANGE CA
92863-5486
US

V. Phone/Fax

Practice location:
  • Phone: 818-795-6549
  • Fax:
Mailing address:
  • Phone: 818-550-0900
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. MINDAUGAS VIELA
Title or Position: PRESIDENT
Credential: MD
Phone: 818-795-6549