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General NPI Number Information
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NPI Number | 1871942466
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Entity Type | Organization
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Legal Business Name | VIRGIL HEALTHCARE
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Dates
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Enumeration Date | 06/06/2016
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Last Update Date | 06/06/2016
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Provider Practice Location Address
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Address Line | 505 S VIRGIL AVE SUITE 101
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City | LOS ANGELES
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State | CA
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Zip | 90020-1406
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Country | US
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Telephone | 213-384-4000
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Fax | 213-351-1320
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Provider Business Mailing Address
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Address Line | 505 S VIRGIL AVE SUITE 101
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City | LOS ANGELES
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State | CA
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Zip | 90020-1406
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Country | US
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Telephone | 213-384-4000
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Fax | 213-351-1320
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Authorized Official
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Title or Position | MD/PRESIDENT
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Name | SONWOO LEE
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Credential |
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Telephone | 213-384-4000
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QU0200X
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Taxonomy Name | Urgent Care Clinic/Center
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License Number | A78556
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License Number State | CA
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