Provider Demographics
NPI:1578081089
Name:VF ALLIANCE, A MEDICAL CORPORATION
Entity Type:Organization
Organization Name:VF ALLIANCE, A MEDICAL CORPORATION
Other - Org Name:VISTA FAMILY HEALTH CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:ANTONIA
Authorized Official - Middle Name:
Authorized Official - Last Name:ROMERO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:760-941-7050
Mailing Address - Street 1:969 S. SANTA FE AVE, STE A
Mailing Address - Street 2:SUITE A
Mailing Address - City:VISTA
Mailing Address - State:CA
Mailing Address - Zip Code:92083-6910
Mailing Address - Country:US
Mailing Address - Phone:760-941-7050
Mailing Address - Fax:760-941-7142
Practice Address - Street 1:969 S. SANTA FE AVE, STE A
Practice Address - Street 2:SUITE A
Practice Address - City:VISTA
Practice Address - State:CA
Practice Address - Zip Code:92083-6910
Practice Address - Country:US
Practice Address - Phone:760-941-7050
Practice Address - Fax:760-941-7142
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-09-05
Last Update Date:2020-01-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA109221207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA1952599938Medicaid