Organization
MID VALLEY VASCULAR CENTER, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. LEO POLOSAJIAN MD (PRESIDENT/CEO)
(818) 454-3638
Entity
Organization
Contact information
Practice address
7640 TAMPA AVE, SUITE 101A, RESEDA, CA 91335-1735
(818) 718-1600
(818) 343-1612
Mailing address
4930 BALBOA BLVD, SUITE 261278, ENCINO, CA 91426-7001
(818) 718-1600
(818) 343-1612
Taxonomy
Speciality
Code
Description
License number
State
261QM1300X
Multi-Specialty Clinic/Center
Primary
—
—
Other
Enumeration date
09/17/2014
Last updated
11/05/2014
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