| Vida Family Practice Pc | |
|
435 Arden Ave Suite # 330 Glendale CA 91203-4016 | |
| (818) 548-8001 | |
| Not Available |
| Full Name | Vida Family Practice Pc |
|---|---|
| Speciality | Clinic/Center |
| Location | 435 Arden Ave, Glendale, California |
| Authorized Official Name and Position | Vigen Vick Abovian (MEDICAL DIRECTOR/PRESIDENT) |
| Authorized Official Contact | 8185888178 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Vida Family Practice Pc Po Box 5869 Glendale CA 91221-5869 Ph: (818) 588-8178 | Vida Family Practice Pc 435 Arden Ave Suite # 330 Glendale CA 91203-4016 Ph: (818) 548-8001 |
| NPI Number | 1245549443 |
|---|---|
| Provider Enumeration Date | 10/05/2010 |
| Last Update Date | 02/07/2014 |
| Medicare PECOS PAC ID | 9436335049 |
|---|---|
| Medicare Enrollment ID | O20110517000140 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1245549443 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QP2300X | Clinic/center - Primary Care | A106757 (California) | Primary |
| Provider Name | Vigen Vick Abovian |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1104135391 PECOS PAC ID: 0345426953 Enrollment ID: I20110517000149 |
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