Organization
VIC MEDICAL SERVICES INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. IKE F UDENGWU SR. PA (SECRETARY)
(310) 493-9393
Entity
Organization
Contact information
Practice address
13658 HAWTHORNE BLVD, SUITE 201, HAWTHORNE, CA 90250-5824
(310) 219-0212
Mailing address
13658 HAWTHORNE BLVD, SUITE 201, HAWTHORNE, CA 90250-5824
(310) 219-0212
Taxonomy
Speciality
Code
Description
License number
State
3245S0500X
Children's Substance Abuse Rehabilitation Facility
Primary
—
—
Other
Enumeration date
02/04/2009
Last updated
02/04/2009
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