Organization Active NPI

Vitagen Medical Corporation

  • Psychiatry Physician
  • Glendora, CA
National Provider Identifier
1740084235
Registry record updated Apr 3, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
Legal business name
VITAGEN MEDICAL CORPORATION
Practice address
1340 E Route 66 Ste 106
Glendora, CA 91740-3783
Phone
(818) 292-4094
NPI assigned
Apr 3, 2025
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 3, 2025

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

Authorized official

Name
Anand MuthiahNPI 1679350078
Title
Managing Director
Phone
(818) 292-4094

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207Q00000X
Addiction Medicine (Psychiatry & Neurology) PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 2084A0401X
Psychiatry PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 2084P0800X Primary
Addiction Psychiatry PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 2084P0802X

Addresses

Primary practice location

1340 E Route 66 Ste 106
Glendora, CA 91740-3783

Mailing address

1039 Stony Brook CT
Claremont, CA 91711-1834
Phone (818) 292-4094

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

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": "1743638400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1743638400000",
    "number": "1740084235",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1039 STONY BROOK CT",
            "city": "CLAREMONT",
            "state": "CA",
            "postal_code": "917111834",
            "telephone_number": "818-292-4094"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1340 E ROUTE 66 STE 106",
            "city": "GLENDORA",
            "state": "CA",
            "postal_code": "917403783",
            "telephone_number": "818-292-4094"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VITAGEN MEDICAL CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-04-03",
        "last_updated": "2025-04-03",
        "certification_date": "2025-04-02",
        "status": "A",
        "authorized_official_last_name": "MUTHIAH",
        "authorized_official_first_name": "ANAND",
        "authorized_official_title_or_position": "MANAGING DIRECTOR",
        "authorized_official_telephone_number": "818-292-4094"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2084A0401X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychiatry & Neurology, Addiction Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "2084P0802X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychiatry & Neurology, Addiction Psychiatry",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Glendora, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 3, 2025; 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.