Organization Active NPI

Los Angeles Vascular Services, Inc

  • Vascular Surgery Physician
  • Montebello, CA
National Provider Identifier
1871862607
Registry record updated Jan 12, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Vascular Surgery PhysicianTaxonomy code 2086S0129X
License
A-70962 Issued in CA
Legal business name
LOS ANGELES VASCULAR SERVICES, INC
Practice address
620 W Beverly Blvd
Montebello, CA 90640-3624
Phone
(323) 869-0871
Fax
(323) 869-0875
NPI assigned
Dec 22, 2011
Last updated
Jan 12, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 12, 2024

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

Authorized official

Name
Dr. Guatavo Torres, MD
Title
President
Phone
(323) 869-0871

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Vascular Surgery PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 2086S0129X A-70962 CA Primary

Addresses

Primary practice location

620 W Beverly Blvd
Montebello, CA 90640-3624

Mailing address

1012 W Beverly Blvd
Suite 873
Montebello, CA 90640-4139
Phone (323) 869-0871

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20120216000411 CA Part B Supplier - Clinic/Group Practice 5890953145 Receives reassigned benefits from 1 practitioner
Practice locations: Chino, CA; Montebello, CA

National Provider Directory

National Provider Directory

Locations

120 S Montebello Blvd
Ste C
Montebello, CA 90640

620 W Beverly Blvd
Montebello, CA 90640
Phone (323) 869-0871

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": "1324512000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1705017600000",
    "number": "1871862607",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1012 W BEVERLY BLVD",
            "address_2": "SUITE 873",
            "city": "MONTEBELLO",
            "state": "CA",
            "postal_code": "906404139",
            "telephone_number": "323-869-0871",
            "fax_number": "323-869-0875"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "620 W BEVERLY BLVD",
            "city": "MONTEBELLO",
            "state": "CA",
            "postal_code": "906403624",
            "telephone_number": "323-869-0871",
            "fax_number": "323-869-0875"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LOS ANGELES VASCULAR SERVICES, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-12-22",
        "last_updated": "2024-01-12",
        "certification_date": "2024-01-12",
        "status": "A",
        "authorized_official_last_name": "TORRES",
        "authorized_official_first_name": "GUATAVO",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "323-869-0871",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "2086S0129X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Surgery, Vascular Surgery",
            "state": "CA",
            "license": "A-70962",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Montebello, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 12, 2024; 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.