Provider Demographics
NPI:1134842933
Name:PACIFIC CARDIOVASCULAR AND VEIN INSTITUTE, INC.
Entity type:Organization
Organization Name:PACIFIC CARDIOVASCULAR AND VEIN INSTITUTE, INC.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:TAREN
Authorized Official - Middle Name:
Authorized Official - Last Name:CESSNA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:805-620-3499
Mailing Address - Street 1:100 N BRENT ST STE 201
Mailing Address - Street 2:
Mailing Address - City:VENTURA
Mailing Address - State:CA
Mailing Address - Zip Code:93003-2835
Mailing Address - Country:US
Mailing Address - Phone:805-643-3330
Mailing Address - Fax:
Practice Address - Street 1:100 N BRENT ST STE 201
Practice Address - Street 2:
Practice Address - City:VENTURA
Practice Address - State:CA
Practice Address - Zip Code:93003-2835
Practice Address - Country:US
Practice Address - Phone:805-643-3330
Practice Address - Fax:805-643-3331
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-09-26
Last Update Date:2024-03-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2086S0129XAllopathic & Osteopathic PhysiciansSurgeryVascular SurgeryGroup - Single Specialty