| Vital Well | |
|
3939 Veselich Ave Apt 302 Los Angeles CA 90039-1485 | |
| (808) 595-6237 | |
| Not Available |
| Full Name | Vital Well |
|---|---|
| Speciality | Clinic/center |
| Location | 3939 Veselich Ave Apt 302, Los Angeles, California |
| Authorized Official Name and Position | Elizabeth Vitale (OWNER) |
| Authorized Official Contact | 8085956237 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Vital Well 3939 Veselich Ave Apt 302 Los Angeles CA 90039-1485 Ph: (808) 595-6237 | Vital Well 3939 Veselich Ave Apt 302 Los Angeles CA 90039-1485 Ph: (808) 595-6237 |
| NPI Number | 1164004768 |
|---|---|
| Provider Enumeration Date | 04/22/2021 |
| Last Update Date | 04/22/2021 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1164004768 | NPI | - | NPPES |
| 1114366002 | Medicaid | CA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261Q00000X | Clinic/center | (* (Not Available)) | Primary |
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