# MARA VASCULAR SURGERY CENTER INC.

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

## Provider details

- **NPI number:** 1720956501
- **Authorized official:** RAMSESS KHOSRAVI LLB, RVT (OWNER)
- **Authorized official phone:** (323) 770-9607

## Contact information

- **Practice address:** 1101 BAYSIDE DR STE 100, CORONA DEL MAR, CA 92625-1754
- **Practice address phone:** (747) 777-3188
- **Practice address fax:** (747) 777-4110
- **Mailing address:** 6720 VALLEY CIRCLE BLVD, WEST HILLS, CA 91307-2809

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QA1903X | Ambulatory Surgical Clinic/Center | — | NULL | Yes |

## Other

- **Enumeration date:** 10/24/2025
- **Last updated:** 11/12/2025