Provider Demographics
NPI:1972181493
Name:VASCULAR CARE SPECIALISTS OF LOS ANGELES
Entity Type:Organization
Organization Name:VASCULAR CARE SPECIALISTS OF LOS ANGELES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:PETER
Authorized Official - Middle Name:
Authorized Official - Last Name:LIN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:626-275-9566
Mailing Address - Street 1:488 E SANTA CLARA ST STE 303
Mailing Address - Street 2:
Mailing Address - City:ARCADIA
Mailing Address - State:CA
Mailing Address - Zip Code:91006-7231
Mailing Address - Country:US
Mailing Address - Phone:626-275-9566
Mailing Address - Fax:626-269-9994
Practice Address - Street 1:488 E SANTA CLARA ST STE 303
Practice Address - Street 2:
Practice Address - City:ARCADIA
Practice Address - State:CA
Practice Address - Zip Code:91006-7231
Practice Address - Country:US
Practice Address - Phone:626-275-9566
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-03-29
Last Update Date:2022-11-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2086S0129XAllopathic & Osteopathic PhysiciansSurgeryVascular SurgeryGroup - Single Specialty