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Organization
VDEX MEDICAL GROUP, INC
Active
Organization
VDEX MEDICAL GROUP, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CHARLES WALTER LONG (CEO)
(818) 661-6367
Entity
Organization
Contact information
Practice address
21201 VICTORY BLVD STE 265, CANOGA PARK, CA 91303-4059
(818) 661-6367
(818) 661-6367
Mailing address
21201 VICTORY BLVD STE 265, CANOGA PARK, CA 91303-4059
(818) 661-6367
(818) 661-6367
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
—
—
207RE0101X
Endocrinology, Diabetes & Metabolism Physician
—
—
Other
Enumeration date
10/05/2017
Last updated
10/03/2018
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