GARY LEE VIDOR

Dr GARY LEE VIDOR is a male medical professional, specializing in Psychologist, Clinical. He graduated in 1975.

Contact

1313 FOOTHILL BLVD
SUITE 10
LA CANADA
CA
910112164

Tel: 8187900110

GARY LEE VIDOR Information

Npi 1902872872
Pac Id 8224280607
Professional Enrollment Id I20121211000279
Last Name VIDOR
First Name GARY
Middle Name LEE
Suffix
Gender M
Credential
Medical School Name OTHER
Graduation Year 1975
Primary Specialty PSYCHOLOGIST, CLINICAL
Secondary Specialty 1
Secondary Specialty 2
Secondary Specialty 3
Secondary Specialty 4
All Secondary Specialties
Organization Legal Name
Group Practice Pac Id
Number Of Group Practice Members
Line 1 Street Address 1313 FOOTHILL BLVD
Line 2 Street Address SUITE 10
Marker Of Address Line 2 Suppression
City LA CANADA
State CA
Zip Code 910112164
Phone Number 8187900110
Hospital Affiliation Ccn 1
Hospital Affiliation Lbn 1
Hospital Affiliation Ccn 2
Hospital Affiliation Lbn 2
Hospital Affiliation Ccn 3
Hospital Affiliation Lbn 3
Hospital Affiliation Ccn 4
Hospital Affiliation Lbn 4
Hospital Affiliation Ccn 5
Hospital Affiliation Lbn 5
Professional Accepts Medicare Assignment Y

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