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General NPI Number Information
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NPI Number | 1447982418
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Entity Type | Organization
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Legal Business Name | VITA HEALTH SOLUTIONS INC
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Dates
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Enumeration Date | 06/28/2022
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Last Update Date | 06/29/2022
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Provider Practice Location Address
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Address Line | 2060 MARENGO ST
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City | LOS ANGELES
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State | CA
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Zip | 90033-1353
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Country | US
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Telephone | 213-400-5565
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Fax |
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Provider Business Mailing Address
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Address Line | 2060 MARENGO ST
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City | LOS ANGELES
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State | CA
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Zip | 90033-1353
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Country | US
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Telephone | 213-400-5565
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Fax |
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Authorized Official
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Title or Position | AC ADAPTER POWERED MODE: 6V 1A
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Name | MS. YOUNG PARK
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Credential | AC ADAPTER POWERED M
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Telephone | 213-272-5626
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number |
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License Number State |
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