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Organization
VASCULAR SURGERY GROUP, INC.
Active
Organization
VASCULAR SURGERY GROUP, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ABID C MOGANNAM MD (SECRETARY)
(510) 347-9191
Entity
Organization
Contact information
Practice address
13851 E 14TH ST STE 202, SAN LEANDRO, CA 94578-2627
(510) 357-4006
(510) 347-4712
Mailing address
13851 E 14TH ST STE 202, SAN LEANDRO, CA 94578-2627
(510) 347-9134
Taxonomy
Speciality
Code
Description
License number
State
2086S0129X
Vascular Surgery Physician
Primary
—
NULL
2086S0129X
Vascular Surgery Physician
Primary
—
—
Other
Enumeration date
03/07/2025
Last updated
03/07/2025
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