Organization Active NPI

Mainstream Vascular Diagnostic Imaging Laboratories

  • Vascular Specialist/Technologist Cardiovascular
  • Sacramento, CA
National Provider Identifier
1366560724
Registry record updated Apr 20, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Vascular Specialist/Technologist CardiovascularTaxonomy code 246XC2903X
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

Updated by the provider on Apr 20, 2008

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)CodeLicenseStatePrimary
Vascular Specialist/Technologist CardiovascularGroup: 193400000X SINGLE SPECIALTY GROUP 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 Doing business as

National Provider Directory

National Provider Directory

Locations

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.

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.

Verify at the official NPI Registry.