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General NPI Number Information
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NPI Number | 1043367162
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Entity Type | Organization
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Legal Business Name | ELENA P. VITUG M.D., INC.
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Dates
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Enumeration Date | 01/03/2007
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Last Update Date | 05/05/2011
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Provider Practice Location Address
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Address Line | 502 EUCLID AVE SUITE 201
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City | NATIONAL CITY
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State | CA
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Zip | 91950-2931
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Country | US
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Telephone | 619-475-6204
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Fax | 619-475-5174
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Provider Business Mailing Address
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Address Line | 520 BAYONA LOOP
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City | CHULA VISTA
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State | CA
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Zip | 91910-7967
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Country | US
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Telephone | 619-475-6204
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Fax | 619-475-5174
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. ELENA PENAFLOR VITUG
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Credential | M.D.
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Telephone | 619-475-6204
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QP2300X
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Taxonomy Name | Primary Care Clinic/Center
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License Number | A44349
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License Number State | CA
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