Organization
IMPERIAL ENDOVASCULAR PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SHAHROUZ TAHVILIAN MD (OWNER)
(818) 634-0936
Entity
Organization
Contact information
Practice address
207 W LEGION RD, BRAWLEY, CA 92227-7780
(818) 634-0936
Mailing address
PO BOX 7096, STOCKTON, CA 95267-0096
(209) 956-7725
(209) 956-7733
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
—
—
2085R0204X
Vascular & Interventional Radiology Physician
—
—
Other
Enumeration date
07/22/2016
Last updated
09/06/2016
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