Chino Vascular & Surgery Center Inc

Primary specialty

Ambulatory Surgical Clinic/CenterTaxonomy code 261QA1903X

Legal business name

CHINO VASCULAR & SURGERY CENTER INC

Practice address

11760 Central Ave Ste 204
Chino, CA 91710-1909

Phone

(714) 754-1684

Fax

(714) 966-0417

NPI assigned

Oct 18, 2019

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Dr. Anil Shah, MDNPI 1619997368

Title

President

Phone

(714) 754-1684

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

Ambulatory surgical center certification: CCN 05C0002267

Legal name

CHINO VASCULAR & SURGERY CENTER INC

Certification status

Active

Provider type (POS)

Ambulatory surgical center

Participating since

Mar 24, 2021

Last certification

Mar 24, 2021

Ownership / control type

Proprietary

Facility address

11760 Central Avenue, Suite 204
Chino, CA 91710

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Anil Vallabhdas Shah, M.D.

  • Specialist
  • Santa Ana, CA
  • NPI 1619997368
  Medicare reassignment NPD Authorized official
• Devin Stephen Zarkowsky, MD

  • Vascular Surgery Physician
  • Fallbrook, CA
  • NPI 1689925844
  Medicare reassignment NPD

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1571356800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1579046400000",
    "number": "1023651445",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2621 S BRISTOL ST STE 108",
            "city": "SANTA ANA",
            "state": "CA",
            "postal_code": "927045718",
            "telephone_number": "714-754-1684"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11760 CENTRAL AVE STE 204",
            "city": "CHINO",
            "state": "CA",
            "postal_code": "917101909",
            "telephone_number": "714-754-1684",
            "fax_number": "714-966-0417"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CHINO VASCULAR & SURGERY CENTER INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-10-18",
        "last_updated": "2020-01-15",
        "certification_date": "2020-01-15",
        "status": "A",
        "authorized_official_last_name": "SHAH",
        "authorized_official_first_name": "ANIL",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "714-754-1684",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "261QA1903X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ambulatory Surgical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Chino Valley Family Physicians a Medical Group
• Chino Valley Medical Center
• Chino Valley Medical Group
• Chino Valley Orthopedic Center Inc
• Chino Valley Unified School District Behavioral Health Center (CVUSD Behavioral Health Center)
• Brigette Chiu, MA, CCC-SLP
• Chloe Coo Lacson DDS Inc
• Jonathan Doo Sung Cho, M.D.
• Lauren Cho, LAMFT
• Yong Hun Cho, DMD

• Ambulatory Surgical Clinic/Center in Chino, CA
• Providers in Chino, CA by specialty
• Ambulatory Surgical Clinic/Center in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 15, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; facility enrollments, owners and changes of ownership; Provider of Services certification data.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.