Organization
INTERVENTIONAL VASCULAR INSTITUTE OF SAN JOSE, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ARASH M PADIDAR MD (CEO)
(408) 918-0405
Entity
Organization
Contact information
Practice address
105 N BASCOM AVE, SAN JOSE, CA 95128-1811
(408) 918-0405
Mailing address
1130 TEN ROD RD, D201, NORTH KINGSTOWN, RI 02852-4161
(877) 591-7250
Taxonomy
Speciality
Code
Description
License number
State
2085R0204X
Vascular & Interventional Radiology Physician
Primary
G74857
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
200710410237
LLC/LP
CA
Enumeration date
10/09/2007
Last updated
10/09/2007
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