# VIDA MOBILE CLINIC

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

## Provider details

- **NPI number:** 1447797865
- **Authorized official:** ANA RUIZ (PA-C)
- **Authorized official phone:** (818) 425-9437

## Contact information

- **Practice address:** 16750 INDEX ST, GRANADA HILLS, CA 91344-3606
- **Practice address phone:** (818) 425-9437
- **Mailing address:** 16750 INDEX ST, GRANADA HILLS, CA 91344-3606
- **Mailing address phone:** (818) 425-9437

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QC1500X | Community Health Clinic/Center | — | NULL | Yes |

## Other

- **Enumeration date:** 01/24/2017
- **Last updated:** 01/24/2017