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General NPI Number Information
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NPI Number | 1477343648
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Entity Type | Organization
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Legal Business Name | SUMMIT VIRTUAL HEALTH LLC
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Dates
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Enumeration Date | 05/09/2025
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Last Update Date | 05/09/2025
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Provider Practice Location Address
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Address Line | INFO@AMY.TELEHEALTHPRACTICES.COM 8605 SANTA MONICA BLVD
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City | WEST HOLLYWOOD
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State | CA
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Zip | 90069
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Country | US
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Telephone | 616-322-5479
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Fax |
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Provider Business Mailing Address
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Address Line | INFO@AMY.TELEHEALTHPRACTICES.COM 8605 SANTA MONICA BLVD
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City | WEST HOLLYWOOD
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State | CA
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Zip | 90069
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Country | US
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Telephone | 616-322-5479
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Fax |
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Authorized Official
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Title or Position | PHYSICIAN ASSISTANT
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Name | AMY GRUBER
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Credential | PA
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Telephone | 616-322-5479
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261Q00000X
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Taxonomy Name | Clinic/Center
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License Number |
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License Number State |
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