Vida Family Practice PC

Primary specialty

Primary Care Clinic/CenterTaxonomy code 261QP2300X

License

A106757 Issued in CA

Legal business name

VIDA FAMILY PRACTICE PC

Practice address

435 Arden Ave
Suite # 330
Glendale, CA 91203-4016

Phone

(818) 548-8001

NPI assigned

Oct 5, 2010

Organization subpart

No

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

Authorized official

Name

Vigen Vick Abovian, M.D.NPI 1104135391

Title

Medical Director/President

Phone

(818) 588-8178

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Vigen Vick Abovian, M.D.

  • Family Medicine Physician
  • Glendale, CA
  • NPI 1104135391
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1286236800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1391731200000",
    "number": "1245549443",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 5869",
            "city": "GLENDALE",
            "state": "CA",
            "postal_code": "912215869",
            "telephone_number": "818-588-8178"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "435 ARDEN AVE",
            "address_2": "SUITE # 330",
            "city": "GLENDALE",
            "state": "CA",
            "postal_code": "912034016",
            "telephone_number": "818-548-8001"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VIDA FAMILY PRACTICE PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-10-05",
        "last_updated": "2014-02-07",
        "status": "A",
        "authorized_official_last_name": "ABOVIAN",
        "authorized_official_first_name": "VIGEN",
        "authorized_official_middle_name": "VICK",
        "authorized_official_title_or_position": "MEDICAL DIRECTOR/PRESIDENT",
        "authorized_official_telephone_number": "818-588-8178",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": "CA",
            "license": "A106757",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Teodorico Vianzon III, PTA
• Vibs Co.
• Victor Royale
• Victory Home Health Care, Inc.
• Victory Imaging Network, Inc.
• Larry P Vigilia
• Nirupa Vignarajan, M.D.
• Viktoriias Medical Office Management
• Vincente L Villa, M.D.
• Andrea Suzara Villacarlos, FNP

• Primary Care Clinic/Center in Glendale, CA
• Providers in Glendale, CA by specialty
• Primary Care Clinic/Center in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 7, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.