| NPI | 1508900523 |
|---|---|
| Doing Business As | LAVISTA PRIMARY CARE |
| Entity Type | Organization |
| Authorized Contact | LIEN DUC NGUYEN President 770-270-0290 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: GA 039644) |
| Enumeration Date | 2007-02-16 |
| Last Update Date | 2020-08-22 |