Organization
CALIFORNIA HEALTH MED GR
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JOSEFINA VISTE MD (PHYSICIAN)
(213) 386-0010
Entity
Organization
Contact information
Practice address
635 S WESTLAKE AVE, SUITE 100, LOS ANGELES, CA 90057-3525
(213) 386-0010
(213) 386-4190
Mailing address
635 S WESTLAKE AVE, SUITE 100, LOS ANGELES, CA 90057-3525
(213) 386-0010
(213) 386-4190
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00A388150
—
CA
Enumeration date
12/12/2007
Last updated
04/06/2015
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