Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Victor Collazo Vidales Jr.

Individual provider Physician Assistant · NPI 1184246704

Victor Collazo Vidales Jr. is a Physician Assistant in Sacramento, California. Qualified in 2021, 5 years ago. Practices with Permanente Medical Group Inc, a 10,941-clinician group, accepts Medicare assignment and offers telehealth. Licensed in California.

Years since qualifying
5
Licensed in
CA
In the registry since
2020
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Practice location Address checks out

3701 J St Ste 201
Sacramento, CA 95816-5542
Phone: (916) 569-8484
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Physician Assistant (primary) Taxonomy 363A00000X · Licence 62028 (CA)

Record details

NPI number1184246704
Entity typeIndividual (Type 1)
GenderMale
Sole proprietorNo
NPI enumeratedMay 18, 2020
Last updated in NPPESJuly 7, 2026
Certification dateJuly 7, 2026

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolOTHER
Graduated 2021 (5 years in practice)
Group practice Permanente Medical Group Inc — 10941 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
TelehealthOffers telehealth services

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