# LOS ANGELES VASCULAR SPECIALISTS A PROFESSIONAL MEDICAL CORPORATION

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

## Provider details

- **NPI number:** 1437182136
- **Authorized official:** GEORGE ANDROS M.D. (PRESIDENT)
- **Authorized official phone:** (818) 902-5786

## Contact information

- **Practice address:** 15107 VANOWEN ST, VAN NUYS, CA 91405-4542
- **Practice address phone:** (818) 902-5786
- **Practice address fax:** (818) 904-3708
- **Mailing address:** PO BOX 14250, VAN NUYS, CA 91409-4250
- **Mailing address phone:** (818) 902-5786
- **Mailing address fax:** (818) 904-3708

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 2086S0129X | Vascular Surgery Physician | A19865 | CA | Yes |
| 2086S0129X | Vascular Surgery Physician | A74720 | CA | — |

## Other

- **Enumeration date:** 07/08/2006
- **Last updated:** 02/25/2011

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | CC8660 | RAILROAD MEDICARE | CA |