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1023000122
KEVIN A VIDA
RANCHO MIRAGE, CA
NPI
1023000122
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
363A00000X Physician Assistant
(Licence: CT 000867)
Enumeration Date
2005-08-16
Last Update Date
2012-04-17
Business Address
-- KEVIN A VIDA PA C
39000 BOB HOPE DRIVE HARRY & DIANE RINKER BUILDING
RANCHO MIRAGE, CA 92270-3221
Phone number: 760-568-2684
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Mailing Address
-- KEVIN A VIDA PA C
P.O. BOX 1730
RANCHO MIRAGE, CA 92270-1058
Phone number: 760-568-2684
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