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Organization
SAN FERNANDO VALLEY VASCULAR GROUP A MEDICAL CORPORATION
Active
Organization
SAN FERNANDO VALLEY VASCULAR GROUP A MEDICAL CORPORATION
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LYDIA NASSOURA (DIRECTOR)
(818) 345-6126
Entity
Organization
Contact information
Practice address
18840 VENTURA BLVD STE 100A, TARZANA, CA 91356-3301
(818) 345-6126
(818) 345-5061
Mailing address
18840 VENTURA BLVD STE 100A, TARZANA, CA 91356-3301
(818) 345-6126
(818) 345-5061
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
A062315
CA
Other
Enumeration date
01/04/2007
Last updated
06/18/2024
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