Healthcare Provider Details
I. General information
NPI: 1609093236
Provider Name (Legal Business Name): VILONA MEDICAL GROUP, INC.
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 04/18/2007
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
5546 ROSEMEAD BLVD SUITE 201
TEMPLE CITY CA
91780-1845
US
IV. Provider business mailing address
PO BOX 55901
SHERMAN OAKS CA
91413-0901
US
V. Phone/Fax
- Phone: 626-287-1656
- Fax: 626-287-1562
- Phone: 818-487-9100
- Fax: 818-487-9111
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 111N00000X |
| Taxonomy | Chiropractor |
| License Number | C27771 |
| License Number State | CA |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 208D00000X |
| Taxonomy | General Practice Physician |
| License Number | C24147 |
| License Number State | CA |
VIII. Authorized Official
Name: DR.
GILBERT
D
CALLIS
Title or Position: MEDICAL DIRECTOR
Credential: M.D.
Phone: 818-487-9100