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General NPI Number Information
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NPI Number | 1346166451
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Entity Type | Organization
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Legal Business Name | VITAL SCOPE MEDICAL INC
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Dates
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Enumeration Date | 06/24/2026
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Last Update Date | 06/24/2026
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Provider Practice Location Address
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Address Line | 6600 AVALON BLVD
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City | LOS ANGELES
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State | CA
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Zip | 90003-1959
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Country | US
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Telephone | 323-488-3243
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Fax |
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Provider Business Mailing Address
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Address Line | 8023 BEVERLY BLVD # 1584
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City | LOS ANGELES
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State | CA
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Zip | 90048-4539
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | DO
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Name | JUSTIN COHEN
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Credential | DO
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Telephone | 323-488-3243
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 261QP2300X
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Taxonomy Name | Primary Care Clinic/Center
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License Number |
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License Number State |
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