Organization
GAUTAM VANGIPURAM MD INC
Active
Other names
Beach Cities Retina
Organization subpart
No
Provider details
NPI number
Authorized official
GAUTAM VANGIPURAM MD (PHYSICIAN)
(815) 342-1739
Entity
Organization
Contact information
Practice address
555 PIER AVE STE D, HERMOSA BEACH, CA 90254-3801
(815) 342-1739
Mailing address
3565 COLONIAL AVE, LOS ANGELES, CA 90066-2708
(815) 342-1739
Taxonomy
Speciality
Code
Description
License number
State
207WX0107X
Retina Specialist (Ophthalmology) Physician
Primary
—
—
Other
Enumeration date
02/23/2023
Last updated
02/23/2023
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