| Organization Name: | CANYON MEDICAL CENTER CORPORATION |
| NPI Number: | 1164679718 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | DAVID VESCO (OWNER) |
| Mailing Address: | 4937 Las Virgenes Rd Suite 104 Calabasas |
| State: | CA US |
| Postal Code: | 913022949 |
| Phone Number: | 8188800799 |
| Fax Number: | 8188806689 |
| NPI Enumeration Date: | 08/26/2008 |
| NPI Last Update Date: | 11/14/2014 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 207QA0505X |
| License Number: | 43384A |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | CA |
| Taxonomy Type: | Allopathic & Osteopathic Physicians |
| Taxonomy Classification: | Family Medicine |
| Taxonomy Specialization: | Adult Medicine |
| Taxonomy Definition: | |