Virtual Reality Medical Center

Primary specialty

Clinic/CenterTaxonomy code 261Q00000X

License

G66151 Issued in CA

Legal business name

VIRTUAL REALITY MEDICAL CENTER

Practice address

6160 Cornerstone Court East
Ste 155
San Diego, CA 92121

Phone

(858) 642-0267

Fax

(858) 642-0285

NPI assigned

Oct 19, 2006

Organization subpart

No

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

Authorized official

Name

Mr. Mark Wiederhold, PHD MD FACP

Title

President

Phone

(858) 642-0267

Specialties & licenses 1

Addresses

Tax ID family

Virtual Reality Medical Center2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• Virtual Reality Medical Center

  • Clinical Psychologist
  • San Diego, CA
  • NPI 1396125456
  NPD tax ID

Locations

Practitioners 1

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

• Kathy Ann Vandenburgh, PH.D.

  • Clinical Psychologist
  • San Diego, CA
  • NPI 1760537328
  NPD (past)

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

{
    "created_epoch": "1161216000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1659453769",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6160 CORNERSTONE COURT EAST",
            "address_2": "STE 155",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "92121",
            "telephone_number": "858-642-0267",
            "fax_number": "858-642-0285"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6160 CORNERSTONE COURT EAST",
            "address_2": "STE 155",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "92121",
            "telephone_number": "858-642-0267",
            "fax_number": "858-642-0285"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VIRTUAL REALITY MEDICAL CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-19",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "WIEDERHOLD",
        "authorized_official_first_name": "MARK",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "858-642-0267",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "PHD MD FACP"
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": "CA",
            "license": "G66151",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Virgnia Padua Mattson D.M.D.
• Pawendeep Virk
• Pritbir S Virk, D.O.
• Eileen Caoile Virrey, FNP-BC,APRN,BSN,RN
• Virtual Reality Medical Center
• Virtual Somnologist, Inc
• Virtual Speech Therapy LLC
• Virtuosity Health & Wellness PC
• Carrie Visalli, CD(DONA)
• Lila Vischer

• Clinic/Center in San Diego, CA
• Providers in San Diego, CA by specialty
• Clinic/Center in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.