Provider Demographics
NPI:1881930949
Name:NORTH COUNTY VASCULAR CENTER A CA PROFESSIONAL MEDICAL CORPORATION
Entity type:Organization
Organization Name:NORTH COUNTY VASCULAR CENTER A CA PROFESSIONAL MEDICAL CORPORATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:OSMAN
Authorized Official - Middle Name:
Authorized Official - Last Name:KHAWAR
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:760-745-1551
Mailing Address - Street 1:255 N ELM ST
Mailing Address - Street 2:SUITE 204
Mailing Address - City:ESCONDIDO
Mailing Address - State:CA
Mailing Address - Zip Code:92025-3431
Mailing Address - Country:US
Mailing Address - Phone:760-294-0870
Mailing Address - Fax:760-294-0871
Practice Address - Street 1:255 N ELM ST
Practice Address - Street 2:SUITE 204
Practice Address - City:ESCONDIDO
Practice Address - State:CA
Practice Address - Zip Code:92025-3431
Practice Address - Country:US
Practice Address - Phone:760-294-0870
Practice Address - Fax:760-294-0871
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-12-18
Last Update Date:2012-12-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2085R0204XAllopathic & Osteopathic PhysiciansRadiologyVascular & Interventional RadiologyGroup - Multi-Specialty
No208VP0014XAllopathic & Osteopathic PhysiciansPain MedicineInterventional Pain MedicineGroup - Multi-Specialty