Active NPI
Mainstream Vascular Diagnostic Imaging Laboratories
- Vascular Specialist/Technologist Cardiovascular
- Sacramento, CA
National Provider Identifier
1366560724
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Vascular Specialist/Technologist Cardiovascular
- Legal business name
- MAINSTREAM VASCULAR DIAGNOSTIC IMAGING LABORATORIES
- Practice address
- 1315 Alhambra Blvd
Suite 320
Sacramento, CA 95816-5244 - Phone
- (916) 736-6033
- Fax
- (916) 736-6034
- NPI assigned
- Mar 26, 2007
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Mr. Braden Jared Victor, B.S., R.V.T.
- Title
- Owner
- Phone
- (916) 736-6033
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Vascular Specialist/Technologist Cardiovascular | 246XC2903X | Primary |
Addresses
Primary practice location
1315 Alhambra Blvd
Suite 320
Sacramento, CA 95816-5244
Mailing address
1315 Alhambra Blvd
Suite 320
Sacramento, CA 95816-5244
Phone (916) 736-6033
Other names 1
- Capitol Cardiovascular Imaging Center
National Provider Directory
National Provider DirectoryLocations
1315 Alhambra Blvd
Ste 320
Sacramento, CA 95816
Phone (916) 736-6033
Practitioners & affiliated clinicians
Practitioners 1
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.
-
- Vascular Surgery Physician
- Carmichael, CA
- NPI 1255405924
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1174867200000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1208649600000",
"number": "1366560724",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1315 ALHAMBRA BLVD",
"address_2": "SUITE 320",
"city": "SACRAMENTO",
"state": "CA",
"postal_code": "958165244",
"telephone_number": "916-736-6033",
"fax_number": "916-736-6034"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1315 ALHAMBRA BLVD",
"address_2": "SUITE 320",
"city": "SACRAMENTO",
"state": "CA",
"postal_code": "958165244",
"telephone_number": "916-736-6033",
"fax_number": "916-736-6034"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "MAINSTREAM VASCULAR DIAGNOSTIC IMAGING LABORATORIES",
"organizational_subpart": "NO",
"enumeration_date": "2007-03-26",
"last_updated": "2008-04-20",
"status": "A",
"authorized_official_last_name": "VICTOR",
"authorized_official_first_name": "BRADEN",
"authorized_official_middle_name": "JARED",
"authorized_official_title_or_position": "OWNER",
"authorized_official_telephone_number": "916-736-6033",
"authorized_official_name_prefix": "Mr.",
"authorized_official_credential": "B.S., R.V.T."
},
"taxonomies": [
{
"code": "246XC2903X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Specialist/Technologist Cardiovascular, Vascular Specialist",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"organization_name": "Capitol Cardiovascular Imaging Center",
"code": "3",
"type": "Doing Business As"
}
]
}
Other providers in Sacramento, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 20, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.