Organization
VEIN CLINIC INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. SEUNG GWON M.D. (PRESIDENT)
(760) 353-2244
Entity
Organization
Contact information
Practice address
1699 W MAIN ST, SUITE E, EL CENTRO, CA 92243-2235
(760) 352-3366
Mailing address
PO BOX 1000, EL CENTRO, CA 92244-1000
(760) 353-2244
(760) 353-2431
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
A81046
CA
Other
Enumeration date
08/20/2009
Last updated
11/11/2010
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