Vanguard Vein Centers

Primary specialty

Vascular Surgery PhysicianTaxonomy code 2086S0129X

Legal business name

VANGUARD VEIN CENTERS

Practice address

10884 Santa Monica Blvd Ste 403
Los Angeles, CA 90025-7639

Phone

(310) 709-7460

NPI assigned

Feb 14, 2023

Organization subpart

No

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

Authorized official

Name

Dr. Ollie Joseph Jackson III, MD

Title

Owner

Phone

(310) 709-7460

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1676332800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1676332800000",
    "number": "1699472191",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10884 SANTA MONICA BLVD STE 403",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900257639"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10884 SANTA MONICA BLVD STE 403",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900257639",
            "telephone_number": "310-709-7460"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VANGUARD VEIN CENTERS",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-02-14",
        "last_updated": "2023-02-14",
        "certification_date": "2023-02-14",
        "status": "A",
        "authorized_official_last_name": "JACKSON",
        "authorized_official_first_name": "OLLIE",
        "authorized_official_middle_name": "JOSEPH",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "310-709-7460",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_name_suffix": "III",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "2086S0129X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Surgery, Vascular Surgery",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Mia Vang
• Srija Vangala, MD
• Carleton Thomas Vangsness Jr., MD
• Vanguard Medical Group Inc
• Vanguard Psychiatric Group
• Andre Joseph Vanherle, MD
• Helga Maria Louisa Vanherle, M.D., M.S.
• Shilethia Monique Vanhook
• Michael Vanhouten, PHARMD
• Oralia Vanleuven, LCSW

• Vascular Surgery Physician in Los Angeles, CA
• Providers in Los Angeles, CA by specialty
• Vascular Surgery Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 14, 2023; 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.