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Organization
VERMONT FAMILY CARE MEDICAL CLINIC INC
Active
Organization
VERMONT FAMILY CARE MEDICAL CLINIC INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JOHN RASTEGAR M.D. (PRESIDENT)
(323) 228-4399
Entity
Organization
Contact information
Practice address
640 N ARDEN BLVD, LOS ANGELES, CA 90004-1202
(323) 228-4399
Mailing address
640 N ARDEN BLVD, LOS ANGELES, CA 90004-1202
(323) 228-4399
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
A53847
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00A538471
—
CA
01
—
1609936483
PERSONAL NPI
CA
Enumeration date
05/30/2007
Last updated
06/16/2014
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