Organization
LA VIDA MULTI-SPECIALTY MEDICAL GROUP
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. CHRISTOPHER C CHIDI MD (PRESIDENT)
(310) 214-8677
Entity
Organization
Contact information
Practice address
1400 S GRAND AVE, LOS ANGELES, CA 90015-3048
(213) 765-7500
(213) 765-7390
Mailing address
DEPARTMENT NO 2834, LOS ANGELELS, CA 90084-1236
(310) 214-8677
(310) 921-1718
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
—
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
GR0088190
—
CA
Enumeration date
01/25/2007
Last updated
07/21/2022
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