| Vdex Medical Group, Inc | |
|
21201 Victory Blvd Ste 265 Canoga Park CA 91303-4059 | |
| (818) 661-6367 | |
| (818) 661-6367 |
| Full Name | Vdex Medical Group, Inc |
|---|---|
| Speciality | Internal Medicine |
| Location | 21201 Victory Blvd Ste 265, Canoga Park, California |
| Authorized Official Name and Position | Charles Walter Long (CEO) |
| Authorized Official Contact | 8186616367 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Vdex Medical Group, Inc 21201 Victory Blvd Ste 265 Canoga Park CA 91303-4059 Ph: (818) 661-6367 | Vdex Medical Group, Inc 21201 Victory Blvd Ste 265 Canoga Park CA 91303-4059 Ph: (818) 661-6367 |
| NPI Number | 1962912741 |
|---|---|
| Provider Enumeration Date | 10/05/2017 |
| Last Update Date | 10/03/2018 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1962912741 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | (* (Not Available)) | Primary |
| 207RE0101X | Internal Medicine - Endocrinology, Diabetes & Metabolism | (* (Not Available)) | Secondary |
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