Vascular Cosmetics la

Primary specialty

Thoracic Surgery (Cardiothoracic Vascular Surgery) PhysicianTaxonomy code 208G00000X

Legal business name

VASCULAR COSMETICS LA

Practice address

112 Waterworks Way
Suite 140
Irvine, CA 92618-3168

Phone

(949) 636-7775

NPI assigned

Nov 30, 2018

Organization subpart

No

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

Authorized official

Name

Dr. Reza Khodaverdian, MDNPI 1700050689

Title

President

Phone

(949) 636-7775

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

Locations

Practitioners 2

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

• Reza Khodaverdian, M.D.

  • Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
  • Irvine, CA
  • NPI 1700050689
  Medicare reassignment Authorized official
• Kamran Christopher Rabbani, M.D.

  • Internal Medicine Physician
  • Encino, CA
  • NPI 1053438622
  NPD (past)

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

{
    "created_epoch": "1543536000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1751414400000",
    "number": "1366912446",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "19 HEATHER HILL LN",
            "city": "LAGUNA HILLS",
            "state": "CA",
            "postal_code": "926536043",
            "telephone_number": "801-641-1344",
            "fax_number": "818-484-8243"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "112 WATERWORKS WAY",
            "address_2": "SUITE 140",
            "city": "IRVINE",
            "state": "CA",
            "postal_code": "926183168",
            "telephone_number": "949-636-7775"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1511 W Glenoaks Blvd",
            "address_purpose": "LOCATION",
            "city": "Glendale",
            "state": "CA",
            "postal_code": "912011912",
            "country_code": "US",
            "telephone_number": "818-482-0016",
            "fax_number": "818-484-8243",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "319 S Brand Blvd",
            "address_purpose": "LOCATION",
            "city": "Glendale",
            "state": "CA",
            "postal_code": "912041701",
            "country_code": "US",
            "telephone_number": "818-482-0016",
            "fax_number": "818-484-8243",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "VASCULAR COSMETICS LA",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-11-30",
        "last_updated": "2025-07-02",
        "certification_date": "2025-06-17",
        "status": "A",
        "authorized_official_last_name": "KHODAVERDIAN",
        "authorized_official_first_name": "REZA",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "949-636-7775",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "208G00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Thoracic Surgery (Cardiothoracic Vascular Surgery)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MED LICENSE",
            "identifier": "A127413",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Phillip Vartanyan, MD
• Vasa Anesthesia Services Associates
• Soumili Sai Vasamsetty
• Nicole Vasco
• Vascular and Endovascular Institute of Orange County, a Medical Corpor
• Ashish Vashisht
• Katarina Vasiljevic, M.D.
• Autumn Marina Vasquez
• Daniel Vasquez, A.T.C
• Hector Vasquez Jr.

• Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician in Irvine, CA
• Providers in Irvine, CA by specialty
• Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 2, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.