Organization Active NPI

Experienced Vascular Imaging Corporation

  • Vascular Specialist/Technologist Cardiovascular
  • Newhall, CA
National Provider Identifier
1730361163
Registry record updated Feb 5, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Vascular Specialist/Technologist CardiovascularTaxonomy code 246XC2903X
Legal business name
EXPERIENCED VASCULAR IMAGING CORPORATION
Practice address
23135 Market St
Newhall, CA 91321-3611
Phone
(661) 254-6243
Fax
(661) 254-8532
NPI assigned
Nov 27, 2007
Last updated
Feb 5, 2019By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 5, 2019

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

Authorized official

Name
Barbara Huerta
Title
Chief Financial Officer
Phone
(661) 254-6243

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Vascular Specialist/Technologist Cardiovascular 246XC2903X Primary

Addresses

Primary practice location

23135 Market St
Newhall, CA 91321-3611

Mailing address

23135 Market St
Newhall, CA 91321-3611
Phone (661) 254-6243

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20080616000138 CA Part B Supplier - Independent Diagnostic Testing Facility (Idtf) 3971674136 Practice locations: Newhall, CA

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 2

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": "1196121600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1549324800000",
    "number": "1730361163",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "23135 MARKET ST",
            "city": "NEWHALL",
            "state": "CA",
            "postal_code": "913213611",
            "telephone_number": "661-254-6243",
            "fax_number": "661-254-8532"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "23135 MARKET ST",
            "city": "NEWHALL",
            "state": "CA",
            "postal_code": "913213611",
            "telephone_number": "661-254-6243",
            "fax_number": "661-254-8532"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EXPERIENCED VASCULAR IMAGING CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-11-27",
        "last_updated": "2019-02-05",
        "status": "A",
        "authorized_official_last_name": "HUERTA",
        "authorized_official_first_name": "BARBARA",
        "authorized_official_title_or_position": "CHIEF FINANCIAL OFFICER",
        "authorized_official_telephone_number": "661-254-6243"
    },
    "taxonomies": [
        {
            "code": "246XC2903X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist Cardiovascular, Vascular Specialist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Newhall, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 5, 2019; 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.