Organization
VITALITY MEDICAL CENTER INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LILIA SEROBIAN (SECRETARY)
(818) 805-0005
Entity
Organization
Contact information
Practice address
1648 W GLENOAKS BLVD # 101, GLENDALE, CA 91201-1827
(818) 805-0005
(818) 805-0050
Mailing address
1648 W GLENOAKS BLVD # 101, GLENDALE, CA 91201-1827
(818) 805-0005
(818) 805-0050
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
—
—
208D00000X
General Practice Physician
Primary
—
—
363L00000X
Nurse Practitioner
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
C4208588
CORPORATION NUMBER
CA
Enumeration date
01/18/2019
Last updated
01/18/2019
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