VITAL TOTAL HEALTH MEDICAL GROUP, INC. (NPI# 1386107928) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1386107928 |
| Entity Type | Organization |
| Organization Name | VITAL TOTAL HEALTH MEDICAL GROUP, INC. |
| Practice Address |
710 S Broadway Ste 212 Walnut Creek CA 94596-5219 |
| Mailing Address |
197 Whispering Trees Ln Danville CA 94526-2427 |
| Practice Telephone | 9253889800 |
| Practice Fax Number | 9258888555 |
| Mailing Telephone | 9259159314 |
| Mailing Fax Number | 9258888555 |
| Enumeration Date | 2019-04-10 |
| Last Update Date | 2019-04-10 |
| Authorized Official Name | BENJAMIN GREER (PRESIDENT) |
| Authorized Official Telephone | 9259159314 |
| Authorized Official Credential | MD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 2083A0300X | ||||
| Y | 261QM1300X |
Clinic/Center Specialization: Multi-Specialty |
Ambulatory Health Care Facilities |
| Street Address |
710 S BROADWAY STE 212 |
| City | WALNUT CREEK |
| State | CA |
| Zip Code | 94596-5219 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1427016005 | Janet Marie Burns | Neuromusculoskeletal Medicine & OMM | 710 S Broadway Ste 212, Walnut Creek, CA 94596-5219 | 2006-05-03 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1467917229 | Alison M Khaddour | Behavior Technician | 800 S Broadway Ste. 310, Walnut Creek, CA 94596 | 2019-02-06 |
| 1134683618 | Ian Colas | Respiratory Therapist, Certified | 1425 South Main Street, Walnut Creek, Walnut Creek, CA 94596 | 2019-01-29 |
| 1912474131 | Albert Dizon Miraflores | Behavior Technician | 1910 Olympic Blvd Walnut Creek Ca 94596, Walnut Creek, CA 94596 | 2018-10-25 |
| 1487136834 | Daryn Stier | Social Worker | 80 Norlyn Drive, Walnut Creek, CA 94596 | 2018-09-02 |
| 1831682335 | Jessica Lim | Registered Nurse | 1357 Oakland Blvd, Walnut Creek, CA 94596 | 2018-06-08 |
| 1699278432 | Alanna Everhart | Behavior Technician | 877 Ygnacio Valley Road, Suite 100, Walnut Creek, CA 94596 | 2018-03-16 |
| 1962958108 | Derek Jue Md | Clinic/Center | 1812 San Miguel Drive, Walnut Creek, CA 94596 | 2016-08-28 |
| 1912369711 | Pamela Jean Lister | Marriage & Family Therapist | 2070 N Broadway, #5370, Walnut Creek, CA 94596 | 2016-03-22 |
| 1548635147 | Anne Lamoreaux Anderson | Behavioral Analyst | 800 South Broadway Suite #310, Walnut Creek, CA 94596 | 2015-12-08 |
| 1346619434 | Christine Anne Gotelli | Registered Nurse | 370 N. Civic Drive #311, San Francico, CA 94596 | 2015-09-18 |
| Find all providers in zip 94596 | ||||
| Taxonomy Code | 261QM1300X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Multi-Specialty |
| Definition to come... |
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| 1396261582 | Kenley Emergency Medicine Corporation | Clinic/Center | 100 N Wiget Ln Ste 200, Walnut Creek, CA 94598-5901 | 2017-08-18 |
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| Find all providers with the same taxonomy | ||||
| City | WALNUT CREEK |
| Zip Code | 94596 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.