Organization
SAN ANTONIO VASCULAR SPECIALISTS CORP
Active
Other names
Modern Vascular
Organization subpart
No
Provider details
NPI number
Authorized official
YURY GAMPEL (MANAGER)
(818) 262-6423
Entity
Organization
Contact information
Practice address
9819 HUEBNER RD BLDG 4, SAN ANTONIO, TX 78240-3253
(210) 761-8775
(210) 519-0216
Mailing address
26500 AGOURA RD STE 102-587, CALABASAS, CA 91302-1952
(818) 880-8605
Taxonomy
Speciality
Code
Description
License number
State
2085R0204X
Vascular & Interventional Radiology Physician
Primary
—
—
2471V0106X
Vascular-Interventional Technology Radiologic Technologist
—
—
Other
Enumeration date
05/14/2019
Last updated
10/05/2020
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