Provider Demographics
NPI:1104190941
Name:ORANGE COUNTY VASCULAR SPECIALISTS, INC.
Entity Type:Organization
Organization Name:ORANGE COUNTY VASCULAR SPECIALISTS, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:STEPHEN
Authorized Official - Middle Name:F
Authorized Official - Last Name:LINDSAY
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:949-574-7176
Mailing Address - Street 1:520 SUPERIOR AVE
Mailing Address - Street 2:SUITE 370
Mailing Address - City:NEWPORT BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:92663-3637
Mailing Address - Country:US
Mailing Address - Phone:949-574-7176
Mailing Address - Fax:949-574-7180
Practice Address - Street 1:520 SUPERIOR AVE
Practice Address - Street 2:SUITE 370
Practice Address - City:NEWPORT BEACH
Practice Address - State:CA
Practice Address - Zip Code:92663-3637
Practice Address - Country:US
Practice Address - Phone:949-574-7176
Practice Address - Fax:949-574-7180
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-02-24
Last Update Date:2017-05-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2086S0129XAllopathic & Osteopathic PhysiciansSurgeryVascular SurgeryGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAGA235AOtherMEDICARE PTAN