# GREATER LONG BEACH PERIPHERAL ARTERIAL DISEASE CENTER, A PROFESSIONAL

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Greater Long Beach Peripheral Arterial Disease Center
- **Organization subpart:** No

## Provider details

- **NPI number:** 1871916494
- **Authorized official:** ARVIND MEHTA MD (PRESIDENT)
- **Authorized official phone:** (562) 867-5300

## Contact information

- **Practice address:** 3 W HAWTHORN PKWY, SUITE 410, VERNON HILLS, IL 60061-1446
- **Practice address phone:** (847) 388-2001
- **Practice address fax:** (847) 388-2020
- **Mailing address:** 16506 LAKEWOOD BLVD, SUITE 200, BELLFLOWER, CA 90706-5164
- **Mailing address phone:** (562) 867-5300
- **Mailing address fax:** (562) 867-8666

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207RI0011X | Interventional Cardiology Physician | — | NULL | — |
| 207RI0011X | Interventional Cardiology Physician | — | — | — |
| 2085R0204X | Vascular & Interventional Radiology Physician | — | NULL | Yes |
| 2085R0204X | Vascular & Interventional Radiology Physician | — | — | Yes |
| 2086S0129X | Vascular Surgery Physician | — | NULL | — |
| 2086S0129X | Vascular Surgery Physician | — | — | — |

## Other

- **Enumeration date:** 02/03/2014
- **Last updated:** 02/03/2014