Vascular Laboratory of Santa Rosa, Inc.

Primary specialty

Vascular Sonography Radiologic TechnologistTaxonomy code 2471V0105X

License

C1090923 Issued in CA

Legal business name

VASCULAR LABORATORY OF SANTA ROSA, INC.

Practice address

1111 Sonoma Ave Ste 322
Santa Rosa, CA 95405-4820

Phone

(707) 576-1522

Fax

(707) 576-1523

NPI assigned

May 9, 2007

Organization subpart

No

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

Authorized official

Name

Mr. Robert Richardson, M.D.

Title

Managing Director

Phone

(707) 545-2436

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

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

{
    "created_epoch": "1178668800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1821202003",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1111 SONOMA AVE STE 322",
            "city": "SANTA ROSA",
            "state": "CA",
            "postal_code": "954054820",
            "telephone_number": "707-576-1522",
            "fax_number": "707-576-1523"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1111 SONOMA AVE STE 322",
            "city": "SANTA ROSA",
            "state": "CA",
            "postal_code": "954054820",
            "telephone_number": "707-576-1522",
            "fax_number": "707-576-1523"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VASCULAR LABORATORY OF SANTA ROSA, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-09",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "RICHARDSON",
        "authorized_official_first_name": "ROBERT",
        "authorized_official_title_or_position": "MANAGING DIRECTOR",
        "authorized_official_telephone_number": "707-545-2436",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "2471V0105X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Radiologic Technologist, Vascular Sonography",
            "state": "CA",
            "license": "C1090923",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "GR0006300",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Jennifer Vargas Dominguez
• Yudith Vargas Dominguez
• Ana Vargas-Rios
• Jessica Vargas
• Mindy Vargas, LCSW
• Edita Vasiliauskas, DDS
• Tomas Vasiliauskas, M.D.
• Yessica Vasquez Munoz
• Marleni Vasquez Pimentel, LMT
• Alvin Vasquez

• Radiologic Technologist in Santa Rosa, CA
• Providers in Santa Rosa, CA by specialty
• Radiologic Technologist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.