Organization
VITALVIDA PRIMARY CARE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
GIOVANNI VALENZUELA (OWNER)
(915) 292-9621
Entity
Organization
Contact information
Practice address
2820 W CHARLESTON BLVD # D40, LAS VEGAS, NV 89102-1942
(915) 292-9621
Mailing address
2820 W CHARLESTON BLVD # D40, LAS VEGAS, NV 89102-1942
Taxonomy
Speciality
Code
Description
License number
State
261Q00000X
Clinic/Center
Primary
—
—
Other
Enumeration date
07/15/2024
Last updated
07/15/2024
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