Organization
GREG VIGNA MD CLCP
Active
Organization subpart
No
Provider details
NPI number
Authorized official
EMILY MEYERS (A/R MANAGER)
(805) 963-3757
Entity
Organization
Contact information
Practice address
1303 MABLE AVE, MODESTO, CA 95355
(318) 548-2649
(805) 564-3332
Mailing address
512 E GUTIERREZ ST STE C, SANTA BARBARA, CA 93103-5223
(805) 963-3757
(805) 564-3332
Taxonomy
Speciality
Code
Description
License number
State
208100000X
Physical Medicine & Rehabilitation Physician
Primary
C54741
SD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1376514190
—
CA
Enumeration date
09/18/2017
Last updated
05/01/2018
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