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Organization

VICTORIA MEDICAL, INC.

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. XANTHE VICTORIA M.D. (CEO)
(714) 735-8762
Entity
Organization

Contact information

Practice address
5451 LA PALMA AVE STE 15, LA PALMA, CA 90623-1758
(714) 735-8762
(714) 735-8762
Mailing address
5451 LA PALMA AVE STE 15, LA PALMA, CA 90623-1758
(714) 735-8762
(714) 735-8762

Taxonomy

Speciality
Code
Description
License number
State
207QA0505X
Adult Medicine Physician
Primary
A94865
CA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
00A948650
CA
Enumeration date
01/16/2017
Last updated
01/16/2017
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