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Organization
VIDA COMMUNITY CLINIC
Active
Organization
VIDA COMMUNITY CLINIC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ANA RUIZ PA (ED)
(818) 425-9437
Entity
Organization
Contact information
Practice address
1519 WOODWORTH ST, SAN FERNANDO, CA 91340-4153
(818) 332-0463
Mailing address
10718 WHITE OAK AVE UNIT 6, GRANADA HILLS, CA 91344-4628
(818) 425-9437
Taxonomy
Speciality
Code
Description
License number
State
261QC1500X
Community Health Clinic/Center
Primary
—
NULL
Other
Enumeration date
09/18/2020
Last updated
09/18/2020
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