Healthcare Provider Details

I. General information

NPI: 1629812847
Provider Name (Legal Business Name): VISZION MEDICAL GROUP INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/21/2024
Last Update Date: 06/21/2024
Certification Date: 06/21/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8619 RESEDA BLVD # 210B
NORTHRIDGE CA
91324-4044
US

IV. Provider business mailing address

8619 RESEDA BLVD # 210B
NORTHRIDGE CA
91324-4044
US

V. Phone/Fax

Practice location:
  • Phone: 747-213-7483
  • Fax:
Mailing address:
  • Phone: 747-213-7483
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207QG0300X
TaxonomyGeriatric Medicine (Family Medicine) Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code251B00000X
TaxonomyCase Management Agency
License Number
License Number State

VIII. Authorized Official

Name: WINDY P SALES
Title or Position: CASE MANAGER
Credential:
Phone: 747-213-7483