# VIDA MEDICAL CENTER, INC

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

## Provider details

- **NPI number:** 1629205422
- **Authorized official:** ARMEN YEGHIA NERSECCIAN D.O. (MEDICAL DIRECTOR)
- **Authorized official phone:** (909) 429-8000

## Contact information

- **Practice address:** 16127 FOOTHILL BLVD, FONTANA, CA 92335-3374
- **Practice address phone:** (909) 429-8000
- **Practice address fax:** (909) 429-8705
- **Mailing address:** 16127 FOOTHILL BLVD, FONTANA, CA 92335-3374
- **Mailing address phone:** (909) 429-8000
- **Mailing address fax:** (909) 429-8705

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 208D00000X | General Practice Physician | — | — | Yes |

## Other

- **Enumeration date:** 06/18/2009
- **Last updated:** 10/30/2015