MEDICARE: DR. MINDAUGAS VIELA 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	207L00000X	Anesthesiology Physician	2003-0351	NM
2	207L00000X	Anesthesiology Physician	C55955	CA
3	207LP2900X	Pain Medicine (Anesthesiology) Physician	2003-0351	NM
4	207LP2900X	Pain Medicine (Anesthesiology) Physician	C55955	CA
5	207LP2900X	Pain Medicine (Anesthesiology) Physician	MD00042920	WA
6	207LP2900X	Pain Medicine (Anesthesiology) Physician	0101244451	VA
7	207L00000X	Anesthesiology Physician	MD217721	OR

General Provider Information

NPI Number	:	1518910355
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. MINDAUGAS VIELA M.D.

Provider Business Mailing Address
First Line	:	3959 MADISON RD
Second Line	:
City	:	LA CANADA
State	:	CA
Zip	:	91011-3951
Country	:	US
Telephone Number	:	818-495-5743
Fax Number	:

Provider Business Practice Location Address
First Line	:	1509 WILSON TERRACE
Second Line	:	ADVENTIST HEALTH GLENDALE
City	:	GLENDALE
State	:	CA
Zip	:	91206-4007
Country	:	US
Telephone Number	:	818-409-8000
Fax Number	:

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

Provider Enumeration Date	:	05/19/2006
Last Update Date	:	07/12/2024

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