Healthcare Provider Details

I. General information

NPI: 1023495793
Provider Name (Legal Business Name): DOC VK CORP
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/01/2015
Last Update Date: 07/01/2026
Certification Date: 07/01/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10242 RESEDA BLVD
NORTHRIDGE CA
91324-1459
US

IV. Provider business mailing address

10242 RESEDA BLVD
NORTHRIDGE CA
91324-1459
US

V. Phone/Fax

Practice location:
  • Phone: 805-660-2343
  • Fax:
Mailing address:
  • Phone: 805-660-2343
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License NumberA90860
License Number StateCA

VIII. Authorized Official

Name: VINEETA KESWANI
Title or Position: OWNER
Credential: M.D.
Phone: 818-554-6575