Healthcare Provider Details
I. General information
NPI: 1518910355
Provider Name (Legal Business Name): MINDAUGAS VIELA M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 05/19/2006
Last Update Date: 07/16/2026
Certification Date: 07/16/2026
Deactivation Date:
Reactivation Date:
III. Provider practice location address
8700 BEVERLY BLVD # SB-290
WEST HOLLYWOOD CA
90048-1804
US
IV. Provider business mailing address
3959 MADISON RD
LA CANADA CA
91011-3951
US
V. Phone/Fax
- Phone: 310-423-5841
- Fax:
- Phone: 818-495-5743
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 207LP2900X |
| Taxonomy | Pain Medicine (Anesthesiology) Physician |
| License Number | MD00042920 |
| License Number State | WA |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 207LP2900X |
| Taxonomy | Pain Medicine (Anesthesiology) Physician |
| License Number | 2003-0351 |
| License Number State | NM |
| # 3 | |
| Primary Taxonomy | N |
| Taxonomy Code | 207LP2900X |
| Taxonomy | Pain Medicine (Anesthesiology) Physician |
| License Number | C55955 |
| License Number State | CA |
| # 4 | |
| Primary Taxonomy | N |
| Taxonomy Code | 207L00000X |
| Taxonomy | Anesthesiology Physician |
| License Number | 2003-0351 |
| License Number State | NM |
| # 5 | |
| Primary Taxonomy | N |
| Taxonomy Code | 207LP2900X |
| Taxonomy | Pain Medicine (Anesthesiology) Physician |
| License Number | 0101244451 |
| License Number State | VA |
| # 6 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207L00000X |
| Taxonomy | Anesthesiology Physician |
| License Number | C55955 |
| License Number State | CA |
| # 7 | |
| Primary Taxonomy | N |
| Taxonomy Code | 207L00000X |
| Taxonomy | Anesthesiology Physician |
| License Number | MD217721 |
| License Number State | OR |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: