# SOUTHERN CALIFORNIA VASCULAR GROUP, INC

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

## Provider details

- **NPI number:** 1376905802
- **Authorized official:** SAMMY EGHBALIEH MD (MEDICAL DOCTOR)
- **Authorized official phone:** (310) 914-9150

## Contact information

- **Practice address:** 1530 CAMDEN AVE STE 403, LOS ANGELES, CA 90025-8010
- **Practice address phone:** (310) 914-9150
- **Mailing address:** 1530 CAMDEN AVE STE 403, LOS ANGELES, CA 90025-8010

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 2086S0129X | Vascular Surgery Physician | A133688 | CA | Yes |

## Other

- **Enumeration date:** 03/23/2016
- **Last updated:** 03/23/2016