MEDICARE: SERGIO VEIGA M.D.

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	207Q00000X	Family Medicine Physician	A71569	CA

General Provider Information

NPI Number	:	1427144047
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SERGIO VEIGA M.D.

Provider Business Mailing Address
First Line	:	P.O. BOX 27206
Second Line	:
City	:	LOS ANGELES
State	:	CA
Zip	:	90027
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	1133 S CENTRAL AVE
Second Line	:	STE 2
City	:	GLENDALE
State	:	CA
Zip	:	91204-2212
Country	:	US
Telephone Number	:	818-500-9996
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/04/2006
Last Update Date	:	07/20/2017

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