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General NPI Number Information
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NPI Number | 1346664364
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Entity Type | Individual
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Provider Name | MIRIAM VITELA
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Gender | Female
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Dates
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Enumeration Date | 02/11/2014
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Last Update Date | 02/11/2014
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Provider Practice Location Address
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Address Line | 5425 POMONA BLVD
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City | LOS ANGELES
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State | CA
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Zip | 90022-1716
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Country | US
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Telephone | 323-728-0411
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Fax |
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Provider Business Mailing Address
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Address Line | 1701 COLLEGE VIEW DR APT 4
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City | MONTEREY PARK
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State | CA
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Zip | 91754-5101
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Country | US
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Telephone | 626-343-8013
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 104100000X
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Taxonomy Name | Social Worker
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License Number |
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License Number State |
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