MEDICARE: VIRTUAL MEDICAL SOLUTIONS

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	261QM1300X	Multi-Specialty Clinic/Center

General Provider Information

NPI Number	:	1043937881
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	VIRTUAL MEDICAL SOLUTIONS

Provider Business Mailing Address
First Line	:	9121 ATLANTA AVE # 756
Second Line	:
City	:	HUNTINGTON BEACH
State	:	CA
Zip	:	92646-6309
Country	:	US
Telephone Number	:	949-220-6158
Fax Number	:

Provider Business Practice Location Address
First Line	:	707 E OCEAN BLVD APT 1408
Second Line	:
City	:	LONG BEACH
State	:	CA
Zip	:	90802-5184
Country	:	US
Telephone Number	:	949-220-6158
Fax Number	:

Authorized Official
Title or Position	:	COO
Name	:	MR. JOSEPH KILLEBREW
Credential	:	MBA
Telephone Number	:	949-220-6158

Provider Enumeration Date	:	10/24/2022
Last Update Date	:	10/24/2022

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