NPIMap

Organization Active NPI

Vascular Interventional Group, Inc.

  • Vascular & Interventional Radiology Physician
  • Huntington Park, CA
National Provider Identifier
1508363714
Registry record updated Apr 12, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Vascular & Interventional Radiology PhysicianTaxonomy code 2085R0204X
Legal business name
VASCULAR INTERVENTIONAL GROUP, INC.
Practice address
6601 Rugby Ave Ste 100
Huntington Park, CA 90255-4040
Phone
(818) 949-2631
Fax
(818) 691-2932
NPI assigned
Apr 12, 2018
Last updated
Apr 12, 2018By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 12, 2018

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

Authorized official

Name
Vladimir Zeetser, DPMNPI 1366449985
Title
Authorized Official
Phone
(818) 259-1138

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 & Interventional Radiology Physician 2085R0204X Primary
Podiatrist 213E00000X

Addresses

Primary practice location

6601 Rugby Ave Ste 100
Huntington Park, CA 90255-4040

Mailing address

18375 Ventura Blvd Ste 554
Tarzana, CA 91356-4218
Phone (818) 259-1138

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20190823002296 CA Part B Supplier - Clinic/Group Practice 8426386798 Receives reassigned benefits from 18 practitioners
Practice locations: Huntington Park, CA

National Provider Directory

National Provider Directory

Locations

6601 Rugby Ave
Ste 100
Huntington Park, CA 90255
Phone (323) 749-9770

Practitioners & affiliated clinicians

Practitioners 18

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 18

NPI Registry JSON

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

{
    "created_epoch": "1523491200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1523491200000",
    "number": "1508363714",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "18375 VENTURA BLVD STE 554",
            "city": "TARZANA",
            "state": "CA",
            "postal_code": "913564218",
            "telephone_number": "818-259-1138",
            "fax_number": "818-583-1696"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6601 RUGBY AVE STE 100",
            "city": "HUNTINGTON PARK",
            "state": "CA",
            "postal_code": "902554040",
            "telephone_number": "818-949-2631",
            "fax_number": "818-691-2932"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VASCULAR INTERVENTIONAL GROUP, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-04-12",
        "last_updated": "2018-04-12",
        "status": "A",
        "authorized_official_last_name": "ZEETSER",
        "authorized_official_first_name": "VLADIMIR",
        "authorized_official_title_or_position": "AUTHORIZED OFFICIAL",
        "authorized_official_telephone_number": "818-259-1138",
        "authorized_official_credential": "DPM"
    },
    "taxonomies": [
        {
            "code": "2085R0204X",
            "taxonomy_group": "",
            "desc": "Radiology, Vascular & Interventional Radiology",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "213E00000X",
            "taxonomy_group": "",
            "desc": "Podiatrist",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Huntington Park, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 12, 2018; 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.