Vineyard Medical Services, a Med Corp

NPI #1972976603 in Marina Del Rey, California

Provider Information

NPI Number: 1972976603
Entity Type: Organization
Organization Name: Vineyard Medical Services, a Med Corp
Primary Specialty: Emergency Medicine
Enumeration Date: Nov 3, 2015
Last Updated: Nov 3, 2015

Practice Location

Address: 4650 LINCOLN BLVD
City: Marina Del Rey
State: California
ZIP Code: 90292-6306
Phone: (469) 401-2386

Authorized Official

Name: ANGEL ISCOVICH, M.D.
Title: OFFICER
Phone: (469) 401-2386

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Nurse Practitioner	363L00000X
Physician Assistant	363A00000X
Emergency Medicine	207P00000X	Primary

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