# CAPITAL VASCULAR SURGEONS MEDICAL GROUP INC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1053346189
- **Authorized official:** DR. RICHARD EDWARD WARD MD (PRESIDENT)
- **Authorized official phone:** (916) 733-0660

## Contact information

- **Practice address:** 3855 J ST, SACRAMENTO, CA 95816-5520
- **Practice address phone:** (916) 733-0660
- **Practice address fax:** (916) 733-0665
- **Mailing address:** 3855 J ST, SACRAMENTO, CA 95816-5520
- **Mailing address phone:** (916) 733-0660
- **Mailing address fax:** (916) 733-0665

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 2086S0129X | Vascular Surgery Physician | — | NULL | Yes |
| 2086S0129X | Vascular Surgery Physician | — | — | Yes |

## Other

- **Enumeration date:** 07/11/2006
- **Last updated:** 12/05/2008

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | GR0049280 | — | CA |