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Organization
VITALITY&LONGEVITY MEDICAL CENTER A PROFESSIONAL MEDICAL CORPORATION
Active
Organization
VITALITY&LONGEVITY MEDICAL CENTER A PROFESSIONAL MEDICAL CORPORATION
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. DOUGLAS J HOPPER M.D. (PRESIDENT)
(310) 581-8585
Entity
Organization
Contact information
Practice address
2221 LINCOLN BLVD, SUITE 200, SANTA MONICA, CA 90405-1320
(310) 581-8585
(320) 215-4650
Mailing address
2221 LINCOLN BLVD, SUITE 200, SANTA MONICA, CA 90405-1320
(310) 581-8585
(320) 215-4650
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
A21560
CA
Other
Enumeration date
04/17/2007
Last updated
06/13/2008
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