Provider Demographics
NPI:1962754697
Name:VCD ASSOCIATES LLC
Entity type:Organization
Organization Name:VCD ASSOCIATES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:VASUKI
Authorized Official - Middle Name:
Authorized Official - Last Name:DARAM
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:760-873-3806
Mailing Address - Street 1:39709 DOVER DR
Mailing Address - Street 2:
Mailing Address - City:PALMDALE
Mailing Address - State:CA
Mailing Address - Zip Code:93551-3144
Mailing Address - Country:US
Mailing Address - Phone:760-873-3806
Mailing Address - Fax:
Practice Address - Street 1:151 PIONEER LN
Practice Address - Street 2:
Practice Address - City:BISHOP
Practice Address - State:CA
Practice Address - Zip Code:93514-2557
Practice Address - Country:US
Practice Address - Phone:760-873-3806
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-10-04
Last Update Date:2012-10-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA93866313M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes313M00000XNursing & Custodial Care FacilitiesNursing Facility/Intermediate Care Facility