NPIMap

Organization Active NPI

Vitality Medical Center

  • Clinic/Center
  • Las Vegas, NV
National Provider Identifier
1457591182
Registry record updated Feb 20, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinic/CenterTaxonomy code 261Q00000X
License
5456 Issued in NV
Legal business name
VITALITY MEDICAL CENTER
Practice address
8785 W. Warm Springs Rd.
Suite 109
Las Vegas, NV 89148-1823
Phone
(702) 731-1200
Fax
(702) 736-6302
NPI assigned
Feb 20, 2009
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 20, 2009

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

Authorized official

Name
Samuel Antonio Mujica Trenche, M.D.
Title
Medical Director
Phone
(702) 731-1200

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinic/Center 261Q00000X 5456 NV Primary

Addresses

Primary practice location

8785 W. Warm Springs Rd.
Suite 109
Las Vegas, NV 89148-1823

Mailing address

8785 W Warm Springs Rd
Suite 109
Las Vegas, NV 89148-1823
Phone (702) 731-1200

National Provider Directory

National Provider Directory

Locations

8785 W Warm Springs Rd
Ste 109
Las Vegas, NV 89148
Phone (702) 731-1200

Practitioners & affiliated clinicians

Practitioners 2

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

NPI Registry JSON

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

{
    "created_epoch": "1235088000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1235088000000",
    "number": "1457591182",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8785 W WARM SPRINGS RD",
            "address_2": "SUITE 109",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891481823",
            "telephone_number": "702-731-1200",
            "fax_number": "702-736-6302"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8785 W. WARM SPRINGS RD.",
            "address_2": "SUITE 109",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891481823",
            "telephone_number": "702-731-1200",
            "fax_number": "702-736-6302"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VITALITY MEDICAL CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-02-20",
        "last_updated": "2009-02-20",
        "status": "A",
        "authorized_official_last_name": "MUJICA TRENCHE",
        "authorized_official_first_name": "SAMUEL",
        "authorized_official_middle_name": "ANTONIO",
        "authorized_official_title_or_position": "MEDICAL DIRECTOR",
        "authorized_official_telephone_number": "702-731-1200",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": "NV",
            "license": "5456",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Las Vegas, NV

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 20, 2009; 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.