Organization
VITAL MEDICAL SERVICES LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. ALEX G GHAZALPOUR AHSC, CHS, COE, RPT (CHIEF OPERATING OFFICER)
(818) 905-1700
Entity
Organization
Contact information
Practice address
700 N BRAND BLVD STE 220, GLENDALE, CA 91203-3235
(818) 905-1700
Mailing address
700 N BRAND BLVD STE 220, GLENDALE, CA 91203-3235
(818) 905-1700
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
—
—
207PE0004X
Emergency Medical Services (Emergency Medicine) Physician
—
—
207R00000X
Internal Medicine Physician
—
—
207RI0200X
Infectious Disease Physician
—
—
261QM1300X
Multi-Specialty Clinic/Center
Primary
—
—
Other
Enumeration date
09/18/2020
Last updated
09/18/2020
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