Vitality Medical Center Inc

Primary specialty

General Practice PhysicianTaxonomy code 208D00000X

Legal business name

VITALITY MEDICAL CENTER INC

Practice address

1648 W Glenoaks Blvd # 101
Glendale, CA 91201-1827

Phone

(818) 805-0005

Fax

(818) 805-0050

NPI assigned

Jan 18, 2019

Last updated

Jan 18, 2019By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Lilia Serobian

Title

Secretary

Phone

(818) 805-0005

Specialties & licenses 3

Addresses

Other identifiers 1

Locations

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

{
    "created_epoch": "1547769600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1547769600000",
    "number": "1184198442",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1648 W GLENOAKS BLVD # 101",
            "city": "GLENDALE",
            "state": "CA",
            "postal_code": "912011827",
            "telephone_number": "818-805-0005",
            "fax_number": "818-805-0050"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1648 W GLENOAKS BLVD # 101",
            "city": "GLENDALE",
            "state": "CA",
            "postal_code": "912011827",
            "telephone_number": "818-805-0005",
            "fax_number": "818-805-0050"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VITALITY MEDICAL CENTER INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-01-18",
        "last_updated": "2019-01-18",
        "status": "A",
        "authorized_official_last_name": "SEROBIAN",
        "authorized_official_first_name": "LILIA",
        "authorized_official_title_or_position": "SECRETARY",
        "authorized_official_telephone_number": "818-805-0005"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CORPORATION NUMBER",
            "identifier": "C4208588",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Vitality Home Health Care, Inc.
• Vitamed Hospice Inc
• Danielle Vitolo
• Vituity - Primary Care Glendale PC
• Gary R. Vitullo, DC
• Vivat Skilled Nursing, Inc.

• General Practice Physician in Glendale, CA
• Providers in Glendale, CA by specialty
• General Practice Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 18, 2019; 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.