Provider Demographics
NPI:1518910355
Name:VIELA, MINDAUGAS (MD)
Entity Type:Individual
Prefix:DR
First Name:MINDAUGAS
Middle Name:
Last Name:VIELA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:DR
Other - First Name:MINDAUGAS
Other - Middle Name:
Other - Last Name:VIELAVICIUS
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD
Mailing Address - Street 1:3959 MADISON RD
Mailing Address - Street 2:
Mailing Address - City:LA CANADA
Mailing Address - State:CA
Mailing Address - Zip Code:91011-3951
Mailing Address - Country:US
Mailing Address - Phone:818-495-5743
Mailing Address - Fax:
Practice Address - Street 1:1509 WILSON TERRACE
Practice Address - Street 2:ADVENTIST HEALTH GLENDALE
Practice Address - City:GLENDALE
Practice Address - State:CA
Practice Address - Zip Code:91206-4007
Practice Address - Country:US
Practice Address - Phone:818-409-8000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-05-19
Last Update Date:2023-09-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORMD217721207L00000X
NM2003-0351207L00000X, 207LP2900X
CAC55955207LP2900X, 207L00000X
WAMD00042920207LP2900X
VA0101244451207LP2900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
No207LP2900XAllopathic & Osteopathic PhysiciansAnesthesiologyPain Medicine