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General NPI Number Information
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NPI Number | 1740817675
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Entity Type | Organization
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Legal Business Name | LA VIDA HEALTH SERVICES
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Dates
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Enumeration Date | 03/23/2020
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Last Update Date | 03/23/2020
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Provider Practice Location Address
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Address Line | 1520 PEAR DR
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City | CONCORD
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State | CA
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Zip | 94518-3192
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Country | US
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Telephone | 925-300-6329
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 231082
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City | PLEASANT HILL
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State | CA
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Zip | 94523-5082
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Country | US
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Telephone | 925-300-6329
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. PETER MCDUFF
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Credential | DC
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Telephone | 925-300-6329
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 111N00000X
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Taxonomy Name | Chiropractor
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License Number |
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License Number State |
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