MEDICARE: VARELA MEDICAL GROUP INC.

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

General Provider Information

NPI Number	:	1932608171
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	VARELA MEDICAL GROUP INC.

Provider Business Mailing Address
First Line	:	5233 E BEVERLY BLVD
Second Line	:
City	:	LOS ANGELES
State	:	CA
Zip	:	90022-2020
Country	:	US
Telephone Number	:	323-724-6911
Fax Number	:	323-724-6915

Provider Business Practice Location Address
First Line	:	5233 E BEVERLY BLVD
Second Line	:
City	:	LOS ANGELES
State	:	CA
Zip	:	90022-2020
Country	:	US
Telephone Number	:	323-724-6911
Fax Number	:	323-724-6915

Authorized Official
Title or Position	:	HR MANAGER
Name	:	BRENDA DURAN
Credential	:
Telephone Number	:	323-499-3650

Provider Enumeration Date	:	02/02/2018
Last Update Date	:	02/02/2018

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