Provider Demographics
NPI:1992077192
Name:VITAL HEALTH INSTITUTE
Entity type:Organization
Organization Name:VITAL HEALTH INSTITUTE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:FOUNDER AND MEDICAL DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:ANDREW
Authorized Official - Middle Name:SCOTT
Authorized Official - Last Name:COOK
Authorized Official - Suffix:
Authorized Official - Credentials:MD, FACOG
Authorized Official - Phone:408-358-2511
Mailing Address - Street 1:14830 LOS GATOS BLVD
Mailing Address - Street 2:SUITE 300
Mailing Address - City:LOS GATOS
Mailing Address - State:CA
Mailing Address - Zip Code:95032-2083
Mailing Address - Country:US
Mailing Address - Phone:408-358-2511
Mailing Address - Fax:408-358-1009
Practice Address - Street 1:15055 LOS GATOS BLVD
Practice Address - Street 2:SUITE 250
Practice Address - City:LOS GATOS
Practice Address - State:CA
Practice Address - Zip Code:95032-2083
Practice Address - Country:US
Practice Address - Phone:408-358-2511
Practice Address - Fax:408-358-1009
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-02-02
Last Update Date:2014-12-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA49312174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty