La Vida Health & Wellness Center of Garden Grove

Primary specialty

Geriatric Physical TherapistTaxonomy code 2251G0304X

Legal business name

LA VIDA HEALTH & WELLNESS CENTER OF GARDEN GROVE

Practice address

12062 Valley View St Ste 108a
Garden Grove, CA 92845-1737

Phone

(805) 233-6419

NPI assigned

Aug 30, 2023

Organization subpart

No

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

Authorized official

Name

Jorge Perez de Tagle

Title

Ceo

Phone

(310) 962-4808

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1693353600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1693353600000",
    "number": "1619752292",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12062 VALLEY VIEW ST STE 108A",
            "city": "GARDEN GROVE",
            "state": "CA",
            "postal_code": "928451737",
            "telephone_number": "805-233-6419"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12062 VALLEY VIEW ST STE 108A",
            "city": "GARDEN GROVE",
            "state": "CA",
            "postal_code": "928451737",
            "telephone_number": "805-233-6419"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LA VIDA HEALTH & WELLNESS CENTER OF GARDEN GROVE",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-08-30",
        "last_updated": "2023-08-30",
        "certification_date": "2023-08-30",
        "status": "A",
        "authorized_official_last_name": "PEREZ DE TAGLE",
        "authorized_official_first_name": "JORGE",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "310-962-4808"
    },
    "taxonomies": [
        {
            "code": "2251G0304X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physical Therapist, Geriatrics",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kyung K. Ro, M.D., Professional Corporation
• Gail L'Ecuyer, OT
• La Pearl Dr.Tuan Q Le DDS Inc
• La Pearl LLC
• La Physicians Medical Group
• Oanh Kieu La, D.C.
• Taryn T La, PHARM. D
• Thao La
• Tuan La, PHARMD
• Wendy La

• Geriatric Physical Therapist in Garden Grove, CA
• Providers in Garden Grove, CA by specialty
• Geriatric Physical Therapist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 30, 2023; 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.