Kevin A Vida PA C

NPI 1023000122 - Physician Assistant - 363A00000X

NPI Details
NPI 1023000122
Gender Male
Enumeration Date 08/16/2005
Last Updated 04/17/2012
Entity Type Individual
Active Over 11 years ago
Practice Location
39000 BOB HOPE DRIVE
HARRY & DIANE RINKER BUILDING
RANCHO MIRAGE CA, 92270-3221, US
Phone (760) 568-2684
Fax (760) 837-2259
Business Location
P.O. BOX 1730
RANCHO MIRAGE CA, 92270-1058, US
Phone (760) 568-2684
Fax (760) 837-2202
Toxanomy
Taxonomy Code 363A00000X
License State Connecticut
License Number 000867
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According to our database, Kevin A Vida PA C NPI is 1023000122, taxonomy code is 363A00000X and license number is 000867, license state is located at Connecticut. Kevin A Vida PA C physically located at 39000 Bob Hope Drive, Rancho Mirage CA, 92270-3221. NPI Number Kevin A Vida PA C has the Individual type.

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1023000122 NPI number is provided on an as is basis without warranty of any kind. 1023000122 is maintained by the National Plan & Provider Enumeration System. The contents of Kevin A Vida PA C are for informational purposes only.