Provider Demographics
NPI:1356088413
Name:VITERI, GILBERTO
Entity Type:Individual
Prefix:
First Name:GILBERTO
Middle Name:
Last Name:VITERI
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:GILBERTO
Other - Middle Name:
Other - Last Name:VITERI
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:16003 FORMBY DR
Mailing Address - Street 2:
Mailing Address - City:LA MIRADA
Mailing Address - State:CA
Mailing Address - Zip Code:90638-4925
Mailing Address - Country:US
Mailing Address - Phone:562-307-4293
Mailing Address - Fax:
Practice Address - Street 1:16003 FORMBY DR
Practice Address - Street 2:
Practice Address - City:LA MIRADA
Practice Address - State:CA
Practice Address - Zip Code:90638-4925
Practice Address - Country:US
Practice Address - Phone:562-307-4293
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-05-18
Last Update Date:2022-06-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)