Organization Active NPI

High Desert Vein and Vascular P C

  • Vascular Surgery Physician
  • Apple Valley, CA
National Provider Identifier
1588402887
Registry record updated Jul 30, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Vascular Surgery PhysicianTaxonomy code 2086S0129X
Legal business name
HIGH DESERT VEIN AND VASCULAR P C
Practice address
16008 Kamana Rd Ste 101
Apple Valley, CA 92307-1376
Phone
(760) 683-2199
Fax
(888) 355-9670
NPI assigned
Jul 19, 2024
Last updated
Jul 30, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 30, 2025

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

Authorized official

Name
Omar Z Tahir, MDNPI 1316102544
Title
President
Phone
(760) 515-6260

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 1

Specialty (taxonomy)CodeLicenseStatePrimary
Vascular Surgery Physician 2086S0129X Primary

Addresses

Primary practice location

16008 Kamana Rd Ste 101
Apple Valley, CA 92307-1376

Mailing address

18092 Wika Rd Ste 220
Apple Valley, CA 92307-2132
Phone (760) 515-6260

Other practice location 1

1376 N Waterman Ave
San Bernardino, CA 92404-5313
Phone (760) 683-2199

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20240808000838 CA Part B Supplier - Clinic/Group Practice 3870030844 Receives reassigned benefits from 1 practitioner
Practice locations: Apple Valley, CA; Riverside, CA; San Bernardino, CA

National Provider Directory

National Provider Directory

Locations

16008 Kamana Rd
Ste 101
Apple Valley, CA 92307
Phone (442) 469-4268

1376 N Waterman Ave
Sn Bernrdno, CA 92404
Phone (760) 683-2199

Practitioners & affiliated clinicians

Practitioners 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1721347200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1753833600000",
    "number": "1588402887",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "18092 WIKA RD STE 220",
            "city": "APPLE VALLEY",
            "state": "CA",
            "postal_code": "923072132",
            "telephone_number": "760-515-6260",
            "fax_number": "949-863-8505"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16008 KAMANA RD STE 101",
            "city": "APPLE VALLEY",
            "state": "CA",
            "postal_code": "923071376",
            "telephone_number": "760-683-2199",
            "fax_number": "888-355-9670"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1376 N Waterman Ave",
            "address_purpose": "LOCATION",
            "city": "San Bernardino",
            "state": "CA",
            "postal_code": "924045313",
            "country_code": "US",
            "telephone_number": "760-683-2199",
            "fax_number": "888-355-9670",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "HIGH DESERT VEIN AND VASCULAR P C",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-07-19",
        "last_updated": "2025-07-30",
        "certification_date": "2025-07-30",
        "status": "A",
        "authorized_official_last_name": "TAHIR",
        "authorized_official_first_name": "OMAR",
        "authorized_official_middle_name": "Z",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "760-515-6260",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "2086S0129X",
            "taxonomy_group": "",
            "desc": "Surgery, Vascular Surgery",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Apple Valley, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 30, 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.