Provider Demographics
NPI:1598840464
Name:MGV HEALTH SYSTEMS, INC.
Entity Type:Organization
Organization Name:MGV HEALTH SYSTEMS, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MS
Authorized Official - First Name:HELEN
Authorized Official - Middle Name:FELIX
Authorized Official - Last Name:VIGILIA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:858-573-6837
Mailing Address - Street 1:8765 AERO DR
Mailing Address - Street 2:SUITE 312
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92123-1781
Mailing Address - Country:US
Mailing Address - Phone:858-573-6837
Mailing Address - Fax:858-573-8917
Practice Address - Street 1:8765 AERO DR
Practice Address - Street 2:SUITE 312
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92123-1781
Practice Address - Country:US
Practice Address - Phone:858-573-6837
Practice Address - Fax:858-573-8917
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-26
Last Update Date:2013-08-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA080000744251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA05D0989176OtherCLIA WAIVER
CA1598840464Medicaid
CA80000744OtherCDPH
CA1598840464Medicaid