| Vital Health Medical Group, Inc. | |
|
6245 De Longpre Ave Fl 2 Los Angeles CA 90028-8253 | |
| (323) 499-1350 | |
| (323) 798-3021 |
| Full Name | Vital Health Medical Group, Inc. |
|---|---|
| Speciality | Internal Medicine |
| Location | 6245 De Longpre Ave Fl 2, Los Angeles, California |
| Authorized Official Name and Position | Marcel S Filart (PRESIDENT) |
| Authorized Official Contact | 3234991350 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Vital Health Medical Group, Inc. 6245 De Longpre Ave Fl 2 Los Angeles CA 90028-8253 Ph: (323) 499-1350 | Vital Health Medical Group, Inc. 6245 De Longpre Ave Fl 2 Los Angeles CA 90028-8253 Ph: (323) 499-1350 |
| NPI Number | 1366839656 |
|---|---|
| Provider Enumeration Date | 04/24/2015 |
| Last Update Date | 11/17/2021 |
| Medicare PECOS PAC ID | 4789987215 |
|---|---|
| Medicare Enrollment ID | O20160115002545 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1366839656 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207QG0300X | Family Medicine - Geriatric Medicine | A76022 (California) | Secondary |
| 207RG0300X | Internal Medicine - Geriatric Medicine | A76022 (California) | Primary |
| Provider Name | Marcel S Filart |
|---|---|
| Provider Type | Practitioner - Geriatric Medicine |
| Provider Identifiers | NPI Number: 1396775474 PECOS PAC ID: 3476467416 Enrollment ID: I20031119000672 |
| Provider Name | Byron Flores |
|---|---|
| Provider Type | Practitioner - General Practice |
| Provider Identifiers | NPI Number: 1881601383 PECOS PAC ID: 0042258139 Enrollment ID: I20050511000367 |
| Provider Name | Simon R Valencia |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1053476176 PECOS PAC ID: 6800824475 Enrollment ID: I20100511000252 |
| Provider Name | Jaana Salonsaari |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1568863348 PECOS PAC ID: 1052638376 Enrollment ID: I20150326000452 |
| Provider Name | Roggielyz Padilla |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1124566724 PECOS PAC ID: 3678848264 Enrollment ID: I20171006002983 |
| Provider Name | May Aguilar |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1407255813 PECOS PAC ID: 2668895418 Enrollment ID: I20200821002629 |
| Provider Name | Ramon T Pacina |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1407434004 PECOS PAC ID: 2466855713 Enrollment ID: I20210723000919 |
| Provider Name | John Menard Castillo De Vera |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1437891561 PECOS PAC ID: 0244627966 Enrollment ID: I20220727004174 |
| Provider Name | Chiantall Anne Paras Gil |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1194489435 PECOS PAC ID: 8921483249 Enrollment ID: I20220922000330 |
| Provider Name | Jesse Santoyo |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1437699360 PECOS PAC ID: 6406227453 Enrollment ID: I20230130002078 |
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