# VITA IPA MEDICAL GROUP, PC

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

## Provider details

- **NPI number:** 1619829454
- **Authorized official:** PHILLIP LIM DO (PRESIDENT)
- **Authorized official phone:** (213) 296-0352

## Contact information

- **Practice address:** 305 N HARBOR BLVD STE 219, FULLERTON, CA 92832-1901
- **Practice address phone:** (213) 296-0352
- **Practice address fax:** (213) 277-8747
- **Mailing address:** 2271 W MALVERN AVE \# 1186, FULLERTON, CA 92833-2106
- **Mailing address phone:** (213) 296-0352
- **Mailing address fax:** (213) 277-8747

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 302R00000X | Health Maintenance Organization | — | NULL | Yes |

## Other

- **Enumeration date:** 02/12/2026
- **Last updated:** 02/12/2026