| Vitality Medical Care Llc | |
|
15233 Ventura Blvd Ste 500 Sherman Oaks CA 91403-2231 | |
| (800) 570-8160 | |
| Not Available |
| Full Name | Vitality Medical Care Llc |
|---|---|
| Speciality | Family Medicine |
| Location | 15233 Ventura Blvd Ste 500, Sherman Oaks, California |
| Authorized Official Name and Position | Mark Dorner (MANAGER) |
| Authorized Official Contact | 8005708160 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Vitality Medical Care Llc 15233 Ventura Blvd Ste 500 Sherman Oaks CA 91403-2231 Ph: (800) 570-8160 | Vitality Medical Care Llc 15233 Ventura Blvd Ste 500 Sherman Oaks CA 91403-2231 Ph: (800) 570-8160 |
| NPI Number | 1760231716 |
|---|---|
| Provider Enumeration Date | 05/14/2024 |
| Last Update Date | 06/23/2025 |
| Medicare PECOS PAC ID | 0840739959 |
|---|---|
| Medicare Enrollment ID | O20240903001672 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1760231716 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
| Provider Name | Maria C Ortiz |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1962494641 PECOS PAC ID: 0244226710 Enrollment ID: I20040421000697 |
| Provider Name | Maria J Ordenana |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1063157352 PECOS PAC ID: 2365813912 Enrollment ID: I20230119000652 |
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