Individual
DANIEL V. VIGIL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1920 COLORADO AVE, SANTA MONICA, CA 90404-3414
(310) 319-4700
(310) 453-5106
Mailing address
5767 W CENTURY BLVD STE 400, LOS ANGELES, CA 90045-5631
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
G76613
CA
207QS0010X
Sports Medicine (Family Medicine) Physician
G76613
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1184795155
—
CA
Enumeration date
11/13/2006
Last updated
11/25/2019
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