Healthcare Provider Details

I. General information

NPI: 1487814307
Provider Name (Legal Business Name): VINELAND HEALTH CENTER
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/13/2008
Last Update Date: 06/23/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6047 VINELAND AVE
NORTH HOLLYWOOD CA
91606-4911
US

IV. Provider business mailing address

6047 VINELAND AVE
NORTH HOLLYWOOD CA
91606-4911
US

V. Phone/Fax

Practice location:
  • Phone: 818-942-0123
  • Fax: 818-942-0110
Mailing address:
  • Phone: 818-942-0123
  • Fax: 818-942-0110

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QH0100X
TaxonomyHealth Service Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: ALBERT ASKARINAM
Title or Position: MEDICAL DIRECTOR
Credential: MD
Phone: 818-942-0123