# PRIMO MEDICAL SPA

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1295138758
- **Authorized official:** DR. VINCENT JOSEPH DONATO D.C (OWNER)
- **Authorized official phone:** (310) 621-4951

## Contact information

- **Practice address:** 230 N MARYLAND AVE STE 206A, GLENDALE, CA 91206-4282
- **Practice address phone:** (310) 621-4951
- **Mailing address:** 230 N MARYLAND AVE STE 206A, GLENDALE, CA 91206-4282
- **Mailing address phone:** (310) 621-4951

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 111N00000X | Chiropractor | CA19760 | CA | — |
| 111NN1001X | Nutrition Chiropractor | CA19760 | CA | — |
| 302R00000X | Health Maintenance Organization | G62334 | CA | Yes |

## Other

- **Enumeration date:** 09/29/2014
- **Last updated:** 09/29/2014