Organization
VIRTUAL REALITY MEDICAL CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. MARK WIEDERHOLD PHD MD FACP (PRESIDENT)
(858) 642-0267
Entity
Organization
Contact information
Practice address
6160 CORNERSTONE COURT EAST, STE 155, SAN DIEGO, CA 92121
(858) 642-0267
(858) 642-0285
Mailing address
6160 CORNERSTONE COURT EAST, STE 155, SAN DIEGO, CA 92121
(858) 642-0267
(858) 642-0285
Taxonomy
Speciality
Code
Description
License number
State
261Q00000X
Clinic/Center
Primary
G66151
CA
Other
Enumeration date
10/19/2006
Last updated
08/22/2020
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