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Organization
CALIFORNIA INSTITUTE FOR CARDIOVASCULAR AND LASER VEIN SURG
Active
Organization
CALIFORNIA INSTITUTE FOR CARDIOVASCULAR AND LASER VEIN SURG
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. SAM EBRAHIMI M.D. (OWNER)
(818) 422-5322
Entity
Organization
Contact information
Practice address
16030 VENTURA BLVD STE 605, ENCINO, CA 91436-4471
(818) 422-5322
(818) 578-8476
Mailing address
18375 VENTURA BLVD # 404, TARZANA, CA 91356-4218
(818) 422-5322
(818) 578-8476
Taxonomy
Speciality
Code
Description
License number
State
208G00000X
Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
Primary
A060777
CA
Other
Enumeration date
02/12/2011
Last updated
04/29/2016
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