Organization
VANGUARD VEIN CENTERS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. OLLIE JOSEPH JACKSON III MD (OWNER)
(310) 709-7460
Entity
Organization
Contact information
Practice address
10884 SANTA MONICA BLVD STE 403, LOS ANGELES, CA 90025-7639
(310) 709-7460
Mailing address
10884 SANTA MONICA BLVD STE 403, LOS ANGELES, CA 90025-7639
Taxonomy
Speciality
Code
Description
License number
State
2086S0129X
Vascular Surgery Physician
Primary
—
—
Other
Enumeration date
02/14/2023
Last updated
02/14/2023
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