# VINCENT POGO HEALTH OF NV PC

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

## Provider details

- **NPI number:** 1407557960
- **Authorized official:** NATALIE MALONEY (COO)
- **Authorized official phone:** (805) 975-0006

## Contact information

- **Practice address:** 26342 FAIRSIDE RD, MALIBU, CA 90265-2927
- **Practice address phone:** (805) 975-5006
- **Mailing address:** 2287 MULHOLLAND HWY, \#526, CALABASAS, CA 90290
- **Mailing address phone:** (805) 975-0006

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 1041C0700X | Clinical Social Worker | — | NULL | — |
| 1041C0700X | Clinical Social Worker | — | — | — |
| 2081P2900X | Pain Medicine (Physical Medicine & Rehabilitation) Physician | — | NULL | Yes |
| 2081P2900X | Pain Medicine (Physical Medicine & Rehabilitation) Physician | — | — | Yes |

## Other

- **Enumeration date:** 03/13/2023
- **Last updated:** 06/01/2023