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General NPI Number Information
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NPI Number | 1639979974
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Entity Type | Organization
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Legal Business Name | NEW VITA MEDICAL
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Dates
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Enumeration Date | 03/17/2025
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Last Update Date | 03/17/2025
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Provider Practice Location Address
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Address Line | 9500 BOLSA AVE STE P
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City | WESTMINSTER
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State | CA
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Zip | 92683-5943
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Country | US
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Telephone | 714-395-4648
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Fax |
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Provider Business Mailing Address
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Address Line | 2108 N ST STE 11571
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City | SACRAMENTO
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State | CA
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Zip | 95816-5712
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Country | US
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Telephone | 714-395-4648
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | SIENA ELISA N ONA
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Credential | MD
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Telephone | 714-395-4648
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2081P0004X
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Taxonomy Name | Spinal Cord Injury 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 | 208100000X
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Taxonomy Name | Physical Medicine & Rehabilitation Physician
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License Number |
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License Number State |
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