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General NPI Number Information
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NPI Number | 1619502283
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Entity Type | Organization
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Legal Business Name | VYTAL SURGICAL INSTITUTE INC
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Dates
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Enumeration Date | 03/04/2020
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Last Update Date | 02/05/2025
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Provider Practice Location Address
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Address Line | 19228 VENTURA BLVD STE A
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City | TARZANA
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State | CA
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Zip | 91356-3101
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Country | US
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Telephone | 818-578-5125
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Fax | 818-578-6039
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Provider Business Mailing Address
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Address Line | 19228 VENTURA BLVD STE A
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City | TARZANA
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State | CA
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Zip | 91356-3101
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Country | US
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Telephone | 818-578-5125
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Fax | 818-578-6039
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Authorized Official
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Title or Position | CEO
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Name | FARDIN HAKAKIAN
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Credential | DPM
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Telephone | 818-578-5125
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QA1903X
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Taxonomy Name | Ambulatory Surgical Clinic/Center
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License Number |
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License Number State |
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