NPI Provider: 1003032525
Contact Name: HOPPER J DOUGLAS
Position: PRESIDENT
Phone: (310) 581-8585
Vitality Longevity Medical Center Inc Information:
Vitality Longevity Medical Center Inc organization have npi 1003032525, taxonomy code is 207Q00000X with license number is A21560 in . This Business address located in 2221 Lincoln Blvd, Santa Monica, CA 90405 California.
Practice Location
Address: 2221 Lincoln Blvd, Santa Monica, CA 90405
Phone: (310) 581-8585
Business Location
Address: 2221 Lincoln Blvd, Santa Monica, CA 90405
Phone: (310) 581-8585
Fax: (320) 215-4650
Taxonomy
Taxonomy Code: 207Q00000X
License Number: A21560
License Number of State: CA
Primary Taxonomy Switch: Y
Enumeration Date: 4/17/2007
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