NPIMap

Organization Active NPI

Los Angeles Vascular Specialists a Professional Medical Corporation

  • Vascular Surgery Physician
  • Van Nuys, CA
National Provider Identifier
1437182136
Registry record updated Feb 25, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Vascular Surgery PhysicianTaxonomy code 2086S0129X
License
A19865 Issued in CA
Legal business name
LOS ANGELES VASCULAR SPECIALISTS A PROFESSIONAL MEDICAL CORPORATION
Practice address
15107 Vanowen St
Van Nuys, CA 91405-4542
Phone
(818) 902-5786
Fax
(818) 904-3708
NPI assigned
Jul 8, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 25, 2011

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

Authorized official

Name
George Andros, M.D.NPI 1972540540
Title
President
Phone
(818) 902-5786

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
Vascular Surgery PhysicianGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 2086S0129X A19865 CA Primary
Vascular Surgery PhysicianGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 2086S0129X A74720 CA

Addresses

Primary practice location

15107 Vanowen St
Van Nuys, CA 91405-4542

Mailing address

PO Box 14250
Van Nuys, CA 91409-4250
Phone (818) 902-5786

Other identifiers 1

IdentifierTypeStateIssuer
CC8660OtherCARAILROAD MEDICARE

National Provider Directory

National Provider Directory

Locations

15243 Vanowen St
Ste 203
Van Nuys, CA 91405
Phone (818) 373-7700

Practitioners & affiliated clinicians

Practitioners 4

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": "1152316800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1298592000000",
    "number": "1437182136",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 14250",
            "city": "VAN NUYS",
            "state": "CA",
            "postal_code": "914094250",
            "telephone_number": "818-902-5786",
            "fax_number": "818-904-3708"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15107 VANOWEN ST",
            "city": "VAN NUYS",
            "state": "CA",
            "postal_code": "914054542",
            "telephone_number": "818-902-5786",
            "fax_number": "818-904-3708"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LOS ANGELES VASCULAR SPECIALISTS A PROFESSIONAL MEDICAL CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-08",
        "last_updated": "2011-02-25",
        "status": "A",
        "authorized_official_last_name": "ANDROS",
        "authorized_official_first_name": "GEORGE",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "818-902-5786",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "2086S0129X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Surgery, Vascular Surgery",
            "state": "CA",
            "license": "A19865",
            "primary": true
        },
        {
            "code": "2086S0129X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Surgery, Vascular Surgery",
            "state": "CA",
            "license": "A74720",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "CC8660",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Van Nuys, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 25, 2011; 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.