NPIMap

Organization Active NPI

Greater Long Beach Peripheral Arterial Disease Center, a Professional

  • Vascular & Interventional Radiology Physician
  • Vernon Hills, IL
National Provider Identifier
1871916494
Registry record updated Feb 3, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Vascular & Interventional Radiology PhysicianTaxonomy code 2085R0204X
Legal business name
GREATER LONG BEACH PERIPHERAL ARTERIAL DISEASE CENTER, A PROFESSIONAL
Doing business as
Greater Long Beach Peripheral Arterial Disease Center
Practice address
3 W Hawthorn Pkwy
Suite 410
Vernon Hills, IL 60061-1446
Phone
(847) 388-2001
Fax
(847) 388-2020
NPI assigned
Feb 3, 2014
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 3, 2014

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

Authorized official

Name
Arvind Mehta, MDNPI 1518985613
Title
President
Phone
(562) 867-5300

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 3

Specialty (taxonomy)CodeLicenseStatePrimary
Interventional Cardiology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207RI0011X
Vascular & Interventional Radiology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 2085R0204X Primary
Vascular Surgery PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 2086S0129X

Addresses

Primary practice location

3 W Hawthorn Pkwy
Suite 410
Vernon Hills, IL 60061-1446

Mailing address

16506 Lakewood Blvd
Suite 200
Bellflower, CA 90706-5164
Phone (562) 867-5300

Other names 1

  • Greater Long Beach Peripheral Arterial Disease Center Doing business as

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.

NPI Registry JSON

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

{
    "created_epoch": "1391385600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1391385600000",
    "number": "1871916494",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16506 LAKEWOOD BLVD",
            "address_2": "SUITE 200",
            "city": "BELLFLOWER",
            "state": "CA",
            "postal_code": "907065164",
            "telephone_number": "562-867-5300",
            "fax_number": "562-867-8666"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3 W HAWTHORN PKWY",
            "address_2": "SUITE 410",
            "city": "VERNON HILLS",
            "state": "IL",
            "postal_code": "600611446",
            "telephone_number": "847-388-2001",
            "fax_number": "847-388-2020"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GREATER LONG BEACH PERIPHERAL ARTERIAL DISEASE CENTER, A PROFESSIONAL",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-02-03",
        "last_updated": "2014-02-03",
        "status": "A",
        "authorized_official_last_name": "MEHTA",
        "authorized_official_first_name": "ARVIND",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "562-867-5300",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207RI0011X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine, Interventional Cardiology",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2085R0204X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Radiology, Vascular & Interventional Radiology",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "2086S0129X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Surgery, Vascular Surgery",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Greater Long Beach Peripheral Arterial Disease Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Vernon Hills, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 3, 2014; 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.