Organization Active NPI

Premier Vascular and Vein Surgery Center

  • Ambulatory Surgical Clinic/Center
  • Turlock, CA
National Provider Identifier
1275350167
Registry record updated Aug 27, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ambulatory Surgical Clinic/CenterTaxonomy code 261QA1903X
Legal business name
PREMIER VASCULAR AND VEIN SURGERY CENTER
Practice address
1512 Colorado Ave
Turlock, CA 95380-2711
Phone
(209) 668-8030
NPI assigned
Sep 23, 2024
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 27, 2026

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

Authorized official

Name
Reza Nazari, MDNPI 1215195557
Title
Owner
Phone
(209) 226-1770

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinic/Center 261Q00000X
Ambulatory Surgical Clinic/Center 261QA1903X Primary

Addresses

Primary practice location

1512 Colorado Ave
Turlock, CA 95380-2711

Mailing address

1512 Colorado Ave
Turlock, CA 95380-2711
Phone (209) 226-1770

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20250121001685 CA Part B Supplier - Ambulatory Surgical Center 4183153109 Receives reassigned benefits from 5 practitioners
Practice locations: Turlock, CA

Ambulatory surgical center certification: CCN 55C0001217

Name & address match This certification has no NPI in the Medicare enrollment files. CMS publishes enrollment files for six facility types only, so it was connected to this NPI by matching the name and address CMS publishes for it.

Legal name
Premier Vascular and Vein Surgery Center
Certification status
Active
Provider type (POS)
Ambulatory surgical center
Participating since
Dec 5, 2025
Last certification
Nov 17, 2025
Facility address
1512 Colorado Ave.
Turlock, CA 95380

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
05D2319377Premier Vascular and Vein Surgery1512 Colorado Ave, Turlock, CA 95380Certificate of waiverFeb 26, 2027

National Provider Directory

National Provider Directory

Locations

1512 Colorado Ave
Turlock, CA 95380
Phone (209) 668-8030

Practitioners & affiliated clinicians

Practitioners 5

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

NPI Registry JSON

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

{
    "created_epoch": "1727049600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1787788800000",
    "number": "1275350167",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1512 COLORADO AVE",
            "city": "TURLOCK",
            "state": "CA",
            "postal_code": "953802711",
            "telephone_number": "209-226-1770",
            "fax_number": "209-226-1771"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1512 COLORADO AVE",
            "city": "TURLOCK",
            "state": "CA",
            "postal_code": "953802711",
            "telephone_number": "209-668-8030"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PREMIER VASCULAR AND VEIN SURGERY CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-09-23",
        "last_updated": "2026-08-27",
        "certification_date": "2026-08-27",
        "status": "A",
        "authorized_official_last_name": "NAZARI",
        "authorized_official_first_name": "REZA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "209-226-1770",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QA1903X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ambulatory Surgical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Turlock, CA

Sources for this page

Verify at the official NPI Registry.