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Organization
LOS ANGELES VASCULAR SPECIALISTS A PROFESSIONAL MEDICAL CORPORATION
Active
Organization
LOS ANGELES VASCULAR SPECIALISTS A PROFESSIONAL MEDICAL CORPORATION
Active
Organization subpart
No
Provider details
NPI number
Authorized official
GEORGE ANDROS M.D. (PRESIDENT)
(818) 902-5786
Entity
Organization
Contact information
Practice address
15107 VANOWEN ST, VAN NUYS, CA 91405-4542
(818) 902-5786
(818) 904-3708
Mailing address
PO BOX 14250, VAN NUYS, CA 91409-4250
(818) 902-5786
(818) 904-3708
Taxonomy
Speciality
Code
Description
License number
State
2086S0129X
Vascular Surgery Physician
Primary
A19865
CA
2086S0129X
Vascular Surgery Physician
A74720
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
CC8660
RAILROAD MEDICARE
CA
Enumeration date
07/08/2006
Last updated
02/25/2011
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