Organization
VIBHAY PRASAD, M.D., INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
VIBHAY PRASAD M.D. (OWNER)
(805) 496-4020
Entity
Organization
Contact information
Practice address
1220 LA VENTA DR, SUITE 104, WESTLAKE VILLAGE, CA 91361-3703
(805) 496-4020
(805) 496-4030
Mailing address
PO BOX 90125, LONG BEACH, CA 90809-0125
(800) 404-2353
(562) 795-0676
Taxonomy
Speciality
Code
Description
License number
State
208100000X
Physical Medicine & Rehabilitation Physician
Primary
G75764
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00G757640
—
CA
Enumeration date
07/09/2006
Last updated
04/27/2012
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