Vein Doctor Medical Group Inc.

Primary specialty

Phlebology PhysicianTaxonomy code 202K00000X

License

G35672 Issued in CA

Legal business name

VEIN DOCTOR MEDICAL GROUP INC.

Practice address

1945 E 17TH St Ste 107
Santa Ana, CA 92705-6862

Phone

(714) 500-7714

Fax

(714) 500-7713

NPI assigned

May 12, 2008

Organization subpart

No

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

Authorized official

Name

Ms. Kimberley Sharifi

Title

Credentialing Manager

Phone

(714) 500-7714

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1210550400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1634860800000",
    "number": "1164699880",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1945 E 17TH ST STE 107",
            "city": "SANTA ANA",
            "state": "CA",
            "postal_code": "927056862",
            "telephone_number": "714-500-7714",
            "fax_number": "714-500-7713"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1945 E 17TH ST STE 107",
            "city": "SANTA ANA",
            "state": "CA",
            "postal_code": "927056862",
            "telephone_number": "714-500-7714",
            "fax_number": "714-500-7713"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VEIN DOCTOR MEDICAL GROUP INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-05-12",
        "last_updated": "2021-10-22",
        "certification_date": "2021-10-22",
        "status": "A",
        "authorized_official_last_name": "SHARIFI",
        "authorized_official_first_name": "KIMBERLEY",
        "authorized_official_title_or_position": "CREDENTIALING MANAGER",
        "authorized_official_telephone_number": "714-500-7714",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "202K00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Phlebology",
            "state": "CA",
            "license": "G35672",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Joe Vega
• Noemi Vega
• Roberto Vega
• Sandra Vega
• Susana Vega, LMFT
• Vein Place Inc
• Karen Vejar-Ibarra
• Ricardo Vela, BEHAVIOR ANALYST
• Alma Isabel Velasco, FNP-C
• Diana Velasco

• Phlebology Physician in Santa Ana, CA
• Providers in Santa Ana, CA by specialty
• Phlebology Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 22, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.