Provider Demographics
NPI:1508363714
Name:VASCULAR INTERVENTIONAL GROUP, INC.
Entity Type:Organization
Organization Name:VASCULAR INTERVENTIONAL GROUP, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:AUTHORIZED OFFICIAL
Authorized Official - Prefix:
Authorized Official - First Name:VLADIMIR
Authorized Official - Middle Name:
Authorized Official - Last Name:ZEETSER
Authorized Official - Suffix:
Authorized Official - Credentials:DPM
Authorized Official - Phone:818-259-1138
Mailing Address - Street 1:18375 VENTURA BLVD STE 554
Mailing Address - Street 2:
Mailing Address - City:TARZANA
Mailing Address - State:CA
Mailing Address - Zip Code:91356-4218
Mailing Address - Country:US
Mailing Address - Phone:818-259-1138
Mailing Address - Fax:818-583-1696
Practice Address - Street 1:6601 RUGBY AVE STE 100
Practice Address - Street 2:
Practice Address - City:HUNTINGTON PARK
Practice Address - State:CA
Practice Address - Zip Code:90255-4040
Practice Address - Country:US
Practice Address - Phone:818-949-2631
Practice Address - Fax:818-691-2932
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-04-12
Last Update Date:2018-04-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2085R0204XAllopathic & Osteopathic PhysiciansRadiologyVascular & Interventional RadiologyGroup - Multi-Specialty
No213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatristGroup - Multi-Specialty