# CALIFORNIA INTERVENTIONAL MEDICAL GROUP

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

## Provider details

- **NPI number:** 1588917322
- **Authorized official:** ROBERT LEE WORTHINGTON-KIRSCH M.D. (PHYSICIAN)
- **Authorized official phone:** (630) 725-2700

## Contact information

- **Practice address:** 11601 WILSHIRE BLVD, 5TH FLOOR, LOS ANGELES, CA 99025
- **Practice address phone:** (630) 725-2737
- **Mailing address:** 1901 BUTTERFIELD RD., SUITE 220, DOWNERS GROVE, IL 60515-1279
- **Mailing address phone:** (630) 725-2700
- **Mailing address fax:** (630) 725-2783

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 202K00000X | Phlebology Physician | G88795 | CA | Yes |

## Other

- **Enumeration date:** 10/17/2012
- **Last updated:** 10/17/2012