Vitality&Longevity Medical Center a Professional Medical Corporation

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

A21560 Issued in CA

Legal business name

VITALITY&LONGEVITY MEDICAL CENTER A PROFESSIONAL MEDICAL CORPORATION

Practice address

2221 Lincoln Blvd
Suite 200
Santa Monica, CA 90405-1320

Phone

(310) 581-8585

Fax

(320) 215-4650

NPI assigned

Apr 17, 2007

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Dr. Douglas J Hopper, M.D.

Title

President

Phone

(310) 581-8585

Specialties & licenses 1

Addresses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1176768000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1213315200000",
    "number": "1003032525",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2221 LINCOLN BLVD",
            "address_2": "SUITE 200",
            "city": "SANTA MONICA",
            "state": "CA",
            "postal_code": "904051320",
            "telephone_number": "310-581-8585",
            "fax_number": "320-215-4650"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2221 LINCOLN BLVD",
            "address_2": "SUITE 200",
            "city": "SANTA MONICA",
            "state": "CA",
            "postal_code": "904051320",
            "telephone_number": "310-581-8585",
            "fax_number": "320-215-4650"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VITALITY&LONGEVITY MEDICAL CENTER A PROFESSIONAL MEDICAL CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-17",
        "last_updated": "2008-06-13",
        "status": "A",
        "authorized_official_last_name": "HOPPER",
        "authorized_official_first_name": "DOUGLAS",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "310-581-8585",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "A21560",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Renata Visomirskis, LMFT
• Vista del Mar Child and Family Services
• Vista del Mar Child and Family Services
• Vital Diagnostic Services Inc.
• Vitale
• Juliane Da Silva Vitolo
• Kenny Hung Vo I
• Katie Lynn Vogel, MA OTR/L
• Klara Vogel, M.D.
• Amir Vokshoor, M.D.

• Family Medicine Physician in Santa Monica, CA
• Providers in Santa Monica, CA by specialty
• Family Medicine Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 13, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.