Provider Demographics
NPI:1982964805
Name:VASCULAR IMAGING PROFESSIONALS INC
Entity Type:Organization
Organization Name:VASCULAR IMAGING PROFESSIONALS INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MATT
Authorized Official - Middle Name:
Authorized Official - Last Name:LIEBERMAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:877-484-7462
Mailing Address - Street 1:1340 N DYNAMICS ST
Mailing Address - Street 2:SUITE A
Mailing Address - City:ANAHEIM
Mailing Address - State:CA
Mailing Address - Zip Code:92806-1902
Mailing Address - Country:US
Mailing Address - Phone:877-484-7462
Mailing Address - Fax:888-847-6110
Practice Address - Street 1:1340 N DYNAMICS ST
Practice Address - Street 2:SUITE A
Practice Address - City:ANAHEIM
Practice Address - State:CA
Practice Address - Zip Code:92806-1902
Practice Address - Country:US
Practice Address - Phone:877-484-7462
Practice Address - Fax:888-847-6110
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-05-24
Last Update Date:2012-05-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR0208XAmbulatory Health Care FacilitiesClinic/CenterRadiology, Mobile