Organization
LA VASCULAR ACCESS CTR MEDICAL GRP
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JACK E RUBIN MD (AUTHORIZED OFFICAL)
(310) 674-9300
Entity
Organization
Contact information
Practice address
323 N PRAIRIE AVE, SUITE 114, INGLEWOOD, CA 90301-4502
(310) 674-9300
(310) 674-9301
Mailing address
323 N PRAIRIE AVE, SUITE 114, INGLEWOOD, CA 90301-4502
(310) 674-9300
(310) 674-9301
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
GR0105550
MEDI-CAL - GROUP
CA
01
—
W21161
MEDICARE - GROUP
CA
Enumeration date
02/19/2007
Last updated
10/14/2021
About Stedi
Stedi is the only programmable healthcare clearinghouse. You can use Stedi's APIs to process eligibility checks, claims, remits, and more.
Contact us